Influence of statin therapy at time of stroke onset on functional outcome among patients with atrial fibrillation

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:227

Article

Ko, Darae¹  Thigpen, Jonathan L.²  Otis, James A.³  Forster, Kristen⁴  Henault, Lori¹  Quinn, Emily⁵  Tripodis, Yorghos⁵  Berger, Peter B.⁴  Limdi, Nita⁶  Hylek, Elaine M.¹ 

[1] Boston Univ, Sch Med, Dept Med, 801 Massachusetts Ave,Crosstown 2, Boston, MA 02118 USA

[2] Notre Dame Maryland Sch Pharm, Dept Clin & Adm Sci, Baltimore, MD USA

[3] Boston Univ, Sch Med, Dept Neurol, 801 Massachusetts Ave,Crosstown 2, Boston, MA 02118 USA

[4] Geisinger Hlth Syst, Dept Cardiol, Danville, PA USA

[5] Boston Univ, Sch Publ Hlth, Dept Biostat, 801 Massachusetts Ave,Crosstown 2, Boston, MA 02118 USA

[6] Univ Alabama Birmingham, Dept Neurol, UAB Stn, Birmingham, AL 35294 USA

关键词: Atrial fibrillation;    Stroke;    Hydroxymethylglutaryl-CoA reductase;    inhibitors;    Risk factors;    Therapy;   

DOI  :  10.1016/j.ijcard.2016.10.055

来源: Elsevier

【 摘 要 】

Background: Statin pretreatment has been associated with reduced infarct volume in nonlacunar strokes. The effect of statins on functional outcomes of strokes related to atrial fibrillation (AF) is unknown. We aimed to define the influence of prestroke statin use on functional outcome in AF. Methods: We assembled a cohort of consecutive ischemic stroke patients from 2006 to 2010. All patients underwent CT or MRI and were adjudicated by site investigators. AF was confirmed by electrocardiogram in 100% of patients. Site neurologists blinded to the study hypothesis affirmed the type of stroke and assessed the severity of disability at the time of hospital discharge. The frequency of death at 30-days was calculated. Results: Ischemic stroke (n = 1030) resulted in a severe neurological deficit or death (modified Rankin scale = 4) at 30 days in 711 patients (69%). Using multivariable logistic regression models adjusting for factors associated with statin treatment and factors associated with functional outcome, prestroke statin use was associated with a 32% reduction in frequency of severe stroke (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.50-0.92; P = 0.011). Other independent factors associated with severe stroke included older age, female sex, non-White race, diabetes mellitus, prior ischemic stroke, prior venous thromboembolism, and dementia. Conclusion: Ischemic strokes in AF are associated with high mortality and morbidity. Statin use at time of stroke onset among patients with AF was associated in this study with less severe stroke and warrant validation. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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