他汀类药物预处理与急性缺血性脑卒中患者侧支循环及最终梗死体积的关系：一项荟萃分析。

Association of statin pretreatment with collateral circulation and final infarct volume in acute ischemic stroke patients: A meta-analysis.

机构信息

Department of Neurology, Charleston Area Medical Center, West Virginia University-Charleston Division, Charleston, WV, USA.

Second Department of Neurology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece; Stroke Unit, Metropolitan Hospital, Piraeus, Greece.

出版信息

Atherosclerosis. 2019 Mar;282:75-79. doi: 10.1016/j.atherosclerosis.2019.01.006. Epub 2019 Jan 22.

DOI:10.1016/j.atherosclerosis.2019.01.006

PMID:30708178

Abstract

BACKGROUND AND AIMS

Statin pretreatment (SP) is associated with improved outcomes in acute ischemic stroke (AIS) patients. Collateral circulation status and final infarct volume (FIV) are independent predictors of functional outcome in AIS.

METHODS

We sought to evaluate the association of SP with collateral circulation and FIV in AIS patients. We used a random-effects model for all the analyses, and pooled standardized mean differences (SMDs) and odds ratios (OR) on the FIV and collateral status according to SP history, respectively.

RESULTS

We identified 9 eligible studies (1186 AIS patients). History of SP was associated with lower FIV (SMD = 0.25, 95%CI: 0.07-0.42, p = 0.005) compared to negative history of SP. A trend towards good collateral scores was observed in the SP group (OR = 1.45; 95% CI, 0.92-2.29, p = 0.11). Subgroup analysis demonstrated reduced FIV among atherosclerotic stroke patients with history of SP (SMD = 0.49; 95% CI, 0.19-0.80, p = 0.001).

CONCLUSIONS

SP appears to be associated with decreased FIV, especially in atherosclerotic AIS.

摘要

背景与目的

他汀类药物预处理（SP）与急性缺血性脑卒中（AIS）患者的预后改善相关。侧支循环状态和最终梗死体积（FIV）是 AIS 患者功能结局的独立预测因素。

方法

我们旨在评估 AIS 患者中 SP 与侧支循环和 FIV 的相关性。我们对所有分析均采用随机效应模型，根据 SP 史分别对 FIV 和侧支状态进行标准化均数差值（SMD）和比值比（OR）的合并。

结果

我们确定了 9 项符合条件的研究（1186 例 AIS 患者）。与 SP 史阴性相比，SP 史与较低的 FIV（SMD=0.25，95%CI：0.07-0.42，p=0.005）相关。SP 组中观察到良好的侧支评分趋势（OR=1.45；95%CI，0.92-2.29，p=0.11）。亚组分析表明，SP 史的动脉粥样硬化性 AIS 患者的 FIV 降低（SMD=0.49；95%CI，0.19-0.80，p=0.001）。