Tuesday, June 16, 2020

Low-dose statin pretreatment improves function and prognosis of recurrent ischemic stroke patients

I know this is pretreatment so it doesn't apply to us. But has your doctor applied this yet?


1. 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

The latest here:

Low-dose statin pretreatment improves function and prognosis of recurrent ischemic stroke patients

First Published June 7, 2020 Research Article




Statins are effective in improving the prognosis of stroke patients. In clinical practice, low-dose statins are often administered to stroke patients in Asian countries but their effects on the prognosis of recurrent ischemic stroke patients are still unclear.

Data of consecutive recurrent ischemic stroke patients were prospectively collected. The National Institutes of Health Stroke Scale (NIHSS) of admission and discharge and the modified Rankin scale (mRs) of 90 days after stroke onset were adopted to evaluate primary outcomes. Secondary outcomes included the subgroup analysis.

Among 219 patients (mean age 65.41 ± 11.58 years), 150 (68.5%) were male. The low-dose statin group had a higher percentage of milder stroke at admission (p < 0.001) and discharge (p < 0.001), and favorable functional outcome at 90 days (p < 0.001). Univariable regression analysis showed that the use of low-dose statins was inversely associated with higher discharge NIHSS [odds ratio (OR) = 0.36, p = 0.009] and higher mRs at 90 days (OR = 0.230, p < 0.001). Multivariable logistic regression analysis revealed that low-dose statins also had a significantly inverse association with higher mRs at 90 days (OR = 0.098, p = 0.049). According to subgroup analysis, a significant effect was found in the good-persistency subgroup (NIHSS score at discharge: OR = 0.051, p = 0.004; mRs score at 3 months: OR = 0.053, p = 0.005), but not in the poor-persistency subgroup.

Low-dose statin pretreatment alleviated stroke severity and improved functional outcomes of recurrent stroke patients.

Stroke is the second most prevalent illness that causes death and disability globally.1 Statins can effectively lower the occurrence and recurrence risk of stroke,2,3 and statin pretreatment is related to better neurological function and prognosis in patients with acute ischemic stroke.4,5
Previous studies were mostly conducted in western countries and whether evidence could be applied to Asian patients remains uncertain. In western countries, high-dose statins are usually prescribed and recommended in guidelines,6 whereas in Asian countries, low-dose statins are mostly used in clinic practice. Statins can lower low-density lipoprotein (LDL-C) values and their efficacy is dose dependent;3 however, it is uncertain whether the effects of low-dose statins are comparable with those of high-dose statins.
At present, low-dose statins are used for the prevention of stroke. The MEGA study revealed that low-dose pravastatin is nonsignificantly related to the incidence of stroke among Japanese.7 The J-STARS study indicated that low-dose pravastatin reduced the recurrence of atherothrombotic stroke in Japanese patients.8 Our previous retrospective study showed that stroke patients pretreated with low-dose statin in western China had better functional outcomes and prognosis for primary prevention.9 However, the retrospective study design could not contain data on all risk factors, which may cause bias for statistical results. Further, the study did not include recurrent stroke patients. Therefore, whether low-dose statins exert effects on the functional outcomes of recurrent ischemic stroke patients is uncertain.
The present study investigated the relationship between low-dose statin pretreatment and prognosis for recurrent ischemic stroke patients, and explored whether different risk factors could affect the effects of statins in Asian patients with recurrent stroke.

No comments:

Post a Comment