Moonis Majaz, Kumar Rajat, Henninger Nils, Kane Kevin, Fisher Marc
Department of Neurology, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts, USA.
Indian J Community Med. 2014 Oct;39(4):214-7. doi: 10.4103/0970-0218.143021.
Although there is sufficient evidence that HMG CoA Reductase Inhibitors reduce stroke recurrence in patients with or ischemic heart disease, it remains unclear whether they also improve outcomes given before or after stroke onset and whether such an effect is more robust with pre-stroke or post-stroke use of statins.
We carried out a retrospective analysis of a large University Health Consortium Database. Patients with statin use before or after stroke onset were included in the analysis. Twenty patients discontinued statins after stroke onset. The outcome measures were discharge home or long-term care facility and/or death within 45 days.
Patients with prior statin use were more likely to be discharged home (1.67, CI 1.12-2.49), as were post stroke statin patients who had a more robust effect OR 2.63, CI 1.61-4.53).
Patients started on statins after stroke were more likely to be discharged home versus patients already on statins before stroke onset. However, both groups were also more likely to be discharged home than those patients not on statins.
尽管有充分证据表明HMG CoA还原酶抑制剂可降低患有缺血性心脏病或中风患者的中风复发率,但尚不清楚在中风发作之前或之后使用这些药物是否也能改善预后,以及他汀类药物在中风前或中风后使用时这种效果是否更强。
我们对一个大型大学健康联盟数据库进行了回顾性分析。分析纳入了在中风发作之前或之后使用他汀类药物的患者。20名患者在中风发作后停用了他汀类药物。结局指标为在45天内出院回家或入住长期护理机构和/或死亡。
中风前使用过他汀类药物的患者更有可能出院回家(比值比1.67,可信区间1.12 - 2.49),中风后使用他汀类药物的患者效果更强(比值比2.63,可信区间1.61 - 4.53),也是如此。
与中风发作前已使用他汀类药物的患者相比,中风后开始使用他汀类药物的患者更有可能出院回家。然而,与未使用他汀类药物的患者相比,这两组患者出院回家的可能性也更大。