SSO Stroke Unit, U.O. Neurologia d.O., DAI di Neuroscienze, Azienda Ospedaliera Universitaria Integrata, Italy.
Neurology. 2013 Feb 12;80(7):655-61. doi: 10.1212/WNL.0b013e318281cc83. Epub 2013 Jan 23.
To assess the impact on stroke outcome of statin use in the acute phase after IV thrombolysis.
Multicenter study on prospectively collected data of 2,072 stroke patients treated with IV thrombolysis. Outcome measures of efficacy were neurologic improvement (NIH Stroke Scale [NIHSS] ≤ 4 points from baseline or NIHSS = 0) and major neurologic improvement (NIHSS ≤ 8 points from baseline or NIHSS = 0) at 7 days and favorable (modified Rankin Scale [mRS] ≤ 2) and excellent functional outcome (mRS ≤ 1) at 3 months. Outcome measures of safety were 7-day neurologic deterioration (NIHSS ≥ 4 points from baseline or death), symptomatic intracerebral hemorrhage type 2 with NIHSS ≥ 4 points from baseline or death within 36 hours, and 3-month death.
Adjusted multivariate analysis showed that statin use in the acute phase was associated with neurologic improvement (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.26-2.25; p < 0.001), major neurologic improvement (OR 1.43, 95% CI 1.11-1.85; p = 0.006), favorable functional outcome (OR 1.63, 95% CI 1.18-2.26; p = 0.003), and a reduced risk of neurologic deterioration (OR: 0.31, 95% CI 0.19-0.53; p < 0.001) and death (OR 0.48, 95% CI 0.28-0.82; p = 0.007).
Statin use in the acute phase of stroke after IV thrombolysis may positively influence short- and long-term outcome.
评估在 IV 溶栓后急性期使用他汀类药物对卒中结局的影响。
这是一项多中心研究,对 2072 例接受 IV 溶栓治疗的卒中患者前瞻性收集的数据进行分析。疗效的测量指标为神经功能改善(基线 NIHSS 评分降低 4 分或 NIHSS 评分为 0)和 7 天时的主要神经功能改善(基线 NIHSS 评分降低 8 分或 NIHSS 评分为 0),以及 3 个月时的良好结局(改良 Rankin 量表评分≤2)和优秀的功能结局(mRS 评分≤1)。安全性的测量指标为 7 天内神经功能恶化(基线 NIHSS 评分增加≥4 分或死亡)、症状性颅内出血(出血性卒中)类型 2(基线 NIHSS 评分增加≥4 分或 36 小时内死亡)和 3 个月内死亡。
调整后的多变量分析显示,在急性期使用他汀类药物与神经功能改善(比值比 [OR] 1.68,95%置信区间 [CI] 1.26-2.25;p < 0.001)、主要神经功能改善(OR 1.43,95% CI 1.11-1.85;p = 0.006)、良好的功能结局(OR 1.63,95% CI 1.18-2.26;p = 0.003)相关,且降低了神经功能恶化(OR:0.31,95% CI 0.19-0.53;p < 0.001)和死亡(OR 0.48,95% CI 0.28-0.82;p = 0.007)的风险。
在 IV 溶栓后卒中的急性期使用他汀类药物可能会对短期和长期结局产生积极影响。