Statin Treatment in the Acute Phase and the Risk of Post-stroke Pneumonia: A Retrospective Cohort Study

If your doctor isn't immediately prescribing statins maybe you should ask why.

Does your hospital have a protocol on statins? If not, your board of directors needs to be fired.

Statins.

tested in rats from 2003

http://Statins induce angiogenesis, neurogenesis, and synaptogenesis after stroke Statins induce angiogenesis, neurogenesis, and synaptogenesis after stroke  

Simvastatin Attenuates Stroke-induced Splenic Atrophy and Lung Susceptibility to Spontaneous Bacterial Infection in Mice

Or,

Simvastatin attenuates axonal injury after experimental traumatic brain injury and promotes neurite outgrowth of primary cortical neurons   October 2012

tested in humans, March, 2011

http://www.medwirenews.com/39/91658/Stroke/Acute_statin_therapy_improves_survival_after_ischemic_stroke.html

And now lost even to the Wayback Machine

So I think this below is the actual research;

Association Between Acute Statin Therapy, Survival, and Improved Functional Outcome After Ischemic Stroke April 2011

The latest here:

 

Statin Treatment in the Acute Phase and the Risk of Post-stroke Pneumonia: A Retrospective Cohort Study

Changling Li^†, Mengmeng Ma^†, Shuju Dong, Ye Hong, Jiajia Bao, Yang Zhang, Lijie Gao, Chaohua Cui, Jian Guo^* and Li He^*

• Department of Neurology, West China Hospital of Sichuan University, Chengdu, China

Background: We aimed to investigate the impact of statin treatment in the acute phase on the risk and severity of post-stroke pneumonia because of the uncertain effects of statins on post-stroke pneumonia.

Methods: Consecutive cases of acute ischemic stroke (AIS) between January 2014 and February 2019 were retrospectively analyzed. Additionally, the association of statin treatment in the acute phase with the risk and severity of post-stroke pneumonia was estimated with logistic regression. We registered the present study in the Chinese Clinical Trial Registry (ChiCTR 2000032838).

Results: Of the 1,258 enrolled patients, no significant difference was observed in post-stroke pneumonia risk between the two groups (with/without statin treatment in the acute phase) after propensity score matching (35.1 vs. 27.9%, p = 0.155). We did not find statin treatment in the acute phase to significantly increase the risk of post-stroke pneumonia both before and after matched analysis [odds ratio (OR) = 1.51, 95% confidence interval (CI) = 0.85–2.67, p = 0.157; OR = 1.57, 95% CI = 0.77–3.18, p = 0.213, respectively]. In the 271 patients with post-stroke pneumonia, no significant difference was found in its severity between two groups (19.6 vs. 19.4%, p = 0.964). No significant association was found between statin treatment and post-stroke pneumonia severity (OR = 0.95, 95% CI = 0.39–2.31, p = 0.918).

Conclusions: There appeared to be no additional benefits of statin treatment in the acute phase for post-stroke pneumonia reduction among AIS patients.

Clinical Trial Registration: http://www.chictr.org.cn, identifier: ChiCTR2000032838.

Introduction

Infectious complications are common and could influence up to 65% of acute ischemic stroke (AIS) patients (1). Post-stroke infections (PSI) are defined as infections that occurred 48 h after the stroke and were not infected or in the latent period of infection at the time of onset (2, 3). Post-stroke pneumonia is a more common type of PSI (4), and ~75% of post-stroke pneumonia occur within the first 72 h of hospitalization (5). In addition, post-stroke pneumonia correlates with a third of early deaths and a fifth of poor outcomes in stroke (4, 6).

Apart from its role in cholesterol reduction, statins have anti-inflammatory, immunomodulatory, antioxidant, and endothelium-stabilizing effects, to name a few (7–10). Several observational studies have shown the effect of early statin use on reducing the infection risk in non-stroke patient populations (11–14). In addition to primary prevention, statins are recommended for secondary prevention of AIS (15, 16). However, the role of statins in post-stroke pneumonia risk is debatable. Whether statin treatment prior to stroke with/without continuous use after admission can reduce the risk of post-stroke pneumonia remains controversial because some studies support it (17, 18) while others do not (19, 20). The impact of statin before stroke on the risk of infection was investigated in many studies, whereas only a few studies gave attention to statin use in the acute phase. Moreover, statin treatment in the acute phase appeared to be associated with a higher post-stroke pneumonia risk (19, 21). Information on the potential effects of statins on post-stroke pneumonia severity in AIS patients is currently unavailable, while the prognosis of stroke patients might be affected by pneumonia severity.

Therefore, we conducted this retrospective study to investigate the impacts of statin on the risk and severity of post-stroke pneumonia in stroke patients during the acute phase.