NDLI: Effect of pretreatment with statins on ischemic stroke outcomes.

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Effect of pretreatment with statins on ischemic stroke outcomes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Mullard, Andrew J. Reeves, Mathew J. Majid, Arshad Jacobs, Bradley S. Gargano, Julia Warner Luo, Zhehui
Description	Country affiliation: United States Author Affiliation: Reeves MJ ( Department of Epidemiology, Michigan State University, B601 West Fee Hall, East Lansing, Michigan 48824, USA. reevesm@msu.edu)
Abstract	BACKGROUND AND PURPOSE: Statins reduce the risk of stroke in at-risk populations and may improve outcomes in patients taking statins before an ischemic stroke (IS). Our objectives were to examine the effects of pretreatment with statins on poor outcome in IS patients. METHODS: Over a 6-month period all acute IS admissions were prospectively identified in 15 hospitals participating in a statewide acute stroke registry. Poor stroke outcome was defined as modified Rankin score >/=4 at discharge (ie, moderate-severe disability or death). Multivariable logistic regression models and matched propensity score analyses were used to quantify the effect of statin pretreatment on poor outcome. RESULTS: Of 1360 IS patients, 23% were using statins before their stroke event and 42% had a poor stroke outcome. After multivariable adjustment, pretreatment with statins was associated with lower odds of poor outcome (OR=0.74, 95% CI 0.52, 1.02). A significant interaction (P<0.01) was found between statin use and race. In whites, statins were associated with statistically significantly lower odds of poor outcome (OR=0.61, 95% CI 0.42, 0.86), but in blacks statins were associated with a nonstatistically significant increase in poor outcome (OR=1.82, 95% CI 0.98, 3.39). Matched propensity score analyses were consistent with the multivariable model results. CONCLUSIONS: Pretreatment with statins was associated with better stroke outcomes in whites, but we found no evidence of a beneficial effect of statins in blacks. These findings indicate the need for further studies, including randomized trials, to examine differential effects of statins on ischemic stroke outcomes among whites and blacks.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	6
Volume Number	39
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2008-06-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Brain Ischemia Drug Therapy Prevention & Control Hydroxymethylglutaryl-coa Reductase Inhibitors Administration & Dosage Hypercholesterolemia Complications Stroke Adolescent African Continental Ancestry Group Brain Drug Effects Metabolism Physiopathology Mortality Cerebral Arteries European Continental Ancestry Group Prospective Studies Multicenter Study Research Support, U.s. Gov't, P.h.s. Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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