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Statin Therapy and ...
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Chroinin, Danielle NiNatl Univ Ireland Univ Coll Dublin, Neurovasc Unit Appl Translat Res & Therapeut, Mater Univ Hosp, Dublin Acad Med Ctr, Dublin, Ireland
(author)
Statin Therapy and Outcome After Ischemic Stroke : Systematic Review and Meta-Analysis of Observational Studies and Randomized Trials
- Article/chapterEnglish2013
Publisher, publication year, extent ...
Numbers
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LIBRIS-ID:oai:DiVA.org:umu-66645
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-66645URI
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https://doi.org/10.1161/STROKEAHA.112.668277DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-195818URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:for swepub-publicationtype
Notes
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Background and Purpose-Although experimental data suggest that statin therapy may improve neurological outcome after acute cerebral ischemia, the results from clinical studies are conflicting. We performed a systematic review and meta-analysis investigating the relationship between statin therapy and outcome after ischemic stroke. Methods-The primary analysis investigated statin therapy at stroke onset (prestroke statin use) and good functional outcome (modified Rankin score 0 to 2) and death. Secondary analyses included the following: (1) acute poststroke statin therapy (<= 72 hours after stroke), and (2) thrombolysis-treated patients. Results-The primary analysis included 113 148 subjects (27 studies). Among observational studies, statin treatment at stroke onset was associated with good functional outcome at 90 days (pooled odds ratio [OR], 1.41; 95% confidence interval [CI], 1.29-1.56; P<0.001), but not 1 year (OR, 1.12; 95% CI, 0.9-1.4; P=0.31), and with reduced fatality at 90 days (pooled OR, 0.71; 95% CI, 0.62-0.82; P<0.001) and 1 year (OR, 0.80;95% CI, 0.67-0.95; P=0.01). In the single randomized controlled trial reporting 90-day functional outcome, statin treatment was associated with good outcome (OR, 1.5; 95% CI, 1.0-2.24; P=0.05). No reduction in fatality was observed on meta-analysis of data from 3 randomized controlled trials (P=0.9). In studies restricted to of thrombolysis-treated patients, an association between statins and increased fatality at 90 days was observed (pooled OR, 1.25; 95% CI, 1.02-1.52; P=0.03, 3 studies, 4339 patients). However, this association was no longer present after adjusting for age and stroke severity in the largest study (adjusted OR, 1.14; 95% CI, 0.90-1.44; 4012 patients). Conclusion-In the largest meta-analysis to date, statin therapy at stroke onset was associated with improved outcome, a finding not observed in studies restricted to thrombolysis-treated patients. Randomized trials of statin therapy in acute ischemic stroke are needed.
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Asplund, KjellUmeå universitet,Medicin,Umeå Univ Hosp, Dept Med, Umeå, Sweden(Swepub:umu)kjas0001
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Åsberg, Signild,1972-Uppsala universitet,Klinisk epidemiologi(Swepub:uu)sigas493
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Callaly, ElizabethNatl Univ Ireland Univ Coll Dublin, Neurovasc Unit Appl Translat Res & Therapeut, Mater Univ Hosp, Dublin Acad Med Ctr, Dublin, Ireland
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Cuadrado-Godia, ElisaHosp del Mar IMIM, Dept Neurol, Barcelona, Spain
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Diez-Tejedor, ExuperioUniv Autonoma Madrid, Dept Neurol, La Paz Univ Hosp, Madrid, Spain; Univ Autonoma Madrid, Stroke Ctr, La Paz Univ Hosp, Madrid, Spain
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Di Napoli, MarioSan Camillo deLellis Gen Hosp, Neurol Serv, Rieti, Italy; Ctr Cardiovasc Med & Cerebrovasc Dis Prevent, SMDN, Laquila, Italy
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Engelter, Stefan T.Univ Basel Hosp, Dept Neurol, Basel, Switzerland
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Furie, Karen L.Massachusetts Gen Hosp, J Philip Kistler Stroke Res Ctr, Ctr Human Genet Res, Boston, MA USA
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Giannopoulos, SotiriosUniv Ioannina, Sch Med, Ioannina, Greece
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Gotto, Antonio M., Jr.Weill Cornell Med Coll, New York, NY USA,Univ Bologna, S Orsola Malpighi Hosp, Bologna, Italy
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Hannon, NiamhNatl Univ Ireland Univ Coll Dublin, Neurovasc Unit Appl Translat Res & Therapeut, Mater Univ Hosp, Dublin Acad Med Ctr, Dublin, Ireland
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Jonsson, FredrikUmeå universitet,Medicin,Umeå Univ Hosp, Dept Med, Umeå, Sweden(Swepub:umu)fikjon98
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Kapral, Moira K.Toronto Gen Hosp, Inst Clin Evaluat Sci, Toronto, ON, Canada
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Marti-Fabregas, JoanHosp Santa Creu & Sant Pau, Barcelona, Spain
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Martinez-Sanchez, PatriciaUniv Autonoma Madrid, Dept Neurol, La Paz Univ Hosp, Madrid, Spain; Univ Autonoma Madrid, Stroke Ctr, La Paz Univ Hosp, Madrid, Spain
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Milionis, Haralampos J.Univ Ioannina, Sch Med, Ioannina, Greece
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Montaner, JoanAutonomous Univ Barcelona, Hosp Vall dHebron, Barcelona, Spain; Autonomous Univ Barcelona, Vall dHebron Res Inst VHIR, Barcelona, Spain
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Muscari, Antonio
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Pikija, SlavenGen Hosp Varazdin, Varazhdin, Croatia
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Probstfield, JeffreyUniv Washington, Dept Med, Seattle, WA USA; Univ Washington, Dept Epidemiol, Seattle, WA USA
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Rost, Natalia S.Massachusetts Gen Hosp, J Philip Kistler Stroke Res Ctr, Ctr Human Genet Res, Boston, MA USA
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Thrift, Amanda G.Monash Univ, Monash Med Ctr, Stroke & Ageing Res Ctr, Dept Med, Clayton, Vic, Australia; Natl Stroke Res Inst, Heidelberg, Vic, Australia
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Vemmos, KonstantinosUniv Athens, Dept Therapeut, Alexandra Hosp, Athens, Greece
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Kelly, Peter J.Natl Univ Ireland Univ Coll Dublin, Neurovasc Unit Appl Translat Res & Therapeut, Mater Univ Hosp, Dublin Acad Med Ctr, Dublin, Ireland
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Natl Univ Ireland Univ Coll Dublin, Neurovasc Unit Appl Translat Res & Therapeut, Mater Univ Hosp, Dublin Acad Med Ctr, Dublin, IrelandMedicin
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In:Stroke44:2, s. 448-4560039-24991524-4628
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Asplund, Kjell
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Callaly, Elizabe ...
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Cuadrado-Godia, ...
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Di Napoli, Mario
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Jonsson, Fredrik
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Milionis, Harala ...
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Montaner, Joan
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