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THRombolysis and STatins(THRaST)研究。

The THRombolysis and STatins (THRaST) study.

机构信息

SSO Stroke Unit, U.O. Neurologia d.O., DAI di Neuroscienze, Azienda Ospedaliera Universitaria Integrata, Italy.

出版信息

Neurology. 2013 Feb 12;80(7):655-61. doi: 10.1212/WNL.0b013e318281cc83. Epub 2013 Jan 23.

DOI:10.1212/WNL.0b013e318281cc83
PMID:23345634
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3590058/
Abstract

OBJECTIVE

To assess the impact on stroke outcome of statin use in the acute phase after IV thrombolysis.

METHODS

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.

RESULTS

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).

CONCLUSION

Statin use in the acute phase of stroke after IV thrombolysis may positively influence short- and long-term outcome.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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Cerebrovasc Dis. 2012;33(4):362-8. doi: 10.1159/000335840. Epub 2012 Mar 14.
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Pre-stroke use of statins on stroke outcome: a meta-analysis of observational studies.他汀类药物在中风预后中的应用:观察性研究的荟萃分析。
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Effect of prior medical treatments on ischemic stroke severity and outcome.既往治疗对缺血性卒中严重程度和预后的影响。
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Neurology. 2011 Aug 30;77(9):888-95. doi: 10.1212/WNL.0b013e31822c9135. Epub 2011 Aug 17.
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Blood pressure change and outcome in acute ischemic stroke: the impact of baseline values, previous hypertensive disease and previous antihypertensive treatment.血压变化与急性缺血性脑卒中的转归:基线值、既往高血压病及既往降压治疗的影响。
J Hypertens. 2011 Aug;29(8):1583-9. doi: 10.1097/HJH.0b013e328348c957.
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Statin pretreatment may increase the risk of symptomatic intracranial haemorrhage in thrombolysis for ischemic stroke: results from a case-control study and a meta-analysis.他汀类药物预处理可能增加缺血性卒中溶栓后症状性颅内出血的风险:一项病例对照研究和荟萃分析的结果。
J Neurol. 2012 Jan;259(1):111-8. doi: 10.1007/s00415-011-6137-3. Epub 2011 Jun 18.
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J Neurol Sci. 2011 Sep 15;308(1-2):128-34. doi: 10.1016/j.jns.2011.05.026. Epub 2011 Jun 16.
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