Department of Neurology and Stroke Center, IdiPAZ Health Research Institute, La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain.
Neurology. 2013 May 7;80(19):1800-5. doi: 10.1212/WNL.0b013e3182918d38. Epub 2013 Apr 17.
To examine the effects of pretreatment with statins at high doses (40 mg of rosuvastatin or 80 mg of any other statin) and low to moderate doses (<40 mg of rosuvastatin or <80 mg of any other statin) on ischemic stroke (IS) severity in clinical practice.
Observational study of IS admissions to our stroke unit over a 3-year period (2008-2010). Mild stroke severity was defined as NIH Stroke Scale score ≤5 on admission. Multivariable regression models and matched propensity score analyses were used to quantify the association of statin pretreatment at high and low to moderate doses with mild stroke severity.
Of the 969 IS patients, 23% were taking low to moderate doses and 4.1% were taking high doses of statins prior to the stroke. Statins were associated with lower NIHSS scores on admission (median [interquartile range] 4 [9] for nonstatin patients, 4 [9] for low to moderate doses of statins, and 2 [4] for high doses of statins; p = 0.010). After multivariable adjustment, pretreatment with statins was associated with a higher probability of mild stroke severity in the unmatched analysis (odds ratio [OR] = 1.637, 95% confidence interval [CI] 1.156-2.319 for the low to moderate doses and OR = 3.297, 95% CI 1.480-7.345 for the high doses of statins) as well as in the propensity score matched analysis (OR = 2.023, 95% CI 1.248-3.281 for the low to moderate doses and OR = 3.502, 95% CI 1.477-8.300 for the high doses of statins).
Pretreatment with statins is associated with lower stroke severity, at high as well as at low to moderate doses.
研究高剂量（40 毫克瑞舒伐他汀或其他任何他汀 80 毫克）和低至中等剂量（瑞舒伐他汀<40 毫克或其他任何他汀<80 毫克）预处理对临床实践中缺血性脑卒中（IS）严重程度的影响。
对我院卒中病房 3 年（2008-2010 年）收治的 IS 患者进行观察性研究。轻度脑卒中严重程度定义为入院时 NIH 脑卒中量表评分≤5。采用多变量回归模型和匹配倾向评分分析，定量分析高剂量和低至中等剂量他汀预处理与轻度脑卒中严重程度的相关性。
969 例 IS 患者中，23%服用低至中等剂量他汀，4.1%服用高剂量他汀。与未服用他汀的患者相比，入院时 NIHSS 评分较低（中位数[四分位数间距]：非他汀组为 4[9]，低至中等剂量他汀组为 4[9]，高剂量他汀组为 2[4]；p=0.010）。多变量调整后，未匹配分析中，他汀预处理与轻度脑卒中严重程度的可能性较高相关（比值比[OR]：低至中等剂量组为 1.637，95%置信区间[CI]：1.156-2.319；高剂量组为 3.297，95%CI：1.480-7.345），在倾向评分匹配分析中也如此（低至中等剂量组为 2.023，95%CI：1.248-3.281；高剂量组为 3.502，95%CI：1.477-8.300）。
高剂量和低至中等剂量他汀预处理与较低的脑卒中严重程度相关。
