Department of Neurology, West China Hospital, Chengdu, Sichuan Province, China.
J Neurol. 2019 Dec;266(12):2970-2978. doi: 10.1007/s00415-019-09520-9. Epub 2019 Aug 29.
Pre-stroke statin use reduces stroke severity and improves functional outcomes; however, whether low-dose statins as a primary preventive measure have similar effects on the Chinese population remains unclear.
Consecutive cases of ischaemic stroke between May 2011 and January 2017 were retrospectively analysed. The primary endpoints were stroke severity on admission and functional outcomes at 90 days. The secondary endpoints were factors related to lower stroke severity on admission. Propensity score matching and logistic regression analyses were performed.
Of the 1878 patients, 6.4% and 23.8% were pre-stroke statin users before and after propensity matching, respectively, reducing the National Institutes of Health Stroke Scale (NIHSS) score on admission from 5 (2-9) to 3 (2-4) (P < 0.001). Patients receiving pretreatment with low-dose statins tended to have a better mRS distribution (median mRS score 2 [1-3] vs. 3 [2-4], P = 0.007) and a higher likelihood of favourable functional outcomes (FFOs) at 90 days (61 [65.6%] vs. 151 [50.8%], P = 0.005). The logistic regression analysis showed that low-dose statins taken before stroke (odds ratio [OR] = 0.15, 95% confidence interval [CI] = 0.08-0.27, P < 0.001) and being male (OR = 0.81, 95% CI = 0.66-0.99, P = 0.035) were related to a lower stroke severity on admission but not among patients with atrial fibrillation (OR = 1.65, 95% CI = 1.12-2.44, P = 0.012) or elevated white blood cell (WBC) counts (OR = 1.12, 95% CI = 1.08-1.17, P < 0.001).
Pretreatment with low-dose statins reduced initial stroke severity, improved functional outcomes at 90 days and was independently associated with a lower stroke severity on admission among Chinese patients.
卒中前使用他汀类药物可降低卒中严重程度并改善功能结局；然而，低剂量他汀类药物作为一级预防措施对中国人群是否具有类似效果尚不清楚。
回顾性分析 2011 年 5 月至 2017 年 1 月连续收治的缺血性卒中患者。主要终点为入院时的卒中严重程度和 90 天的功能结局。次要终点为与入院时卒中严重程度降低相关的因素。进行倾向评分匹配和 logistic 回归分析。
在 1878 例患者中，6.4%和 23.8%的患者在倾向评分匹配前后分别为卒中前他汀类药物使用者，入院时 NIHSS 评分从 5 分（29 分）降至 3 分（24 分）（P<0.001）。接受低剂量他汀类药物预处理的患者倾向于具有更好的 mRS 分布（中位数 mRS 评分 2 [13]比 3 [24]，P=0.007），90 天的良好功能结局（FFO）可能性更高（61 [65.6%]比 151 [50.8%]，P=0.005）。logistic 回归分析显示，卒中前服用低剂量他汀类药物（比值比 [OR] = 0.15，95%置信区间 [CI] = 0.080.27，P<0.001）和男性（OR = 0.81，95% CI = 0.660.99，P=0.035）与入院时的卒中严重程度降低相关，但在房颤（OR = 1.65，95% CI = 1.122.44，P=0.012）或白细胞计数升高（OR = 1.12，95% CI = 1.081.17，P<0.001）的患者中则不然。
中国患者卒中前使用低剂量他汀类药物可降低初始卒中严重程度，改善 90 天的功能结局，且与入院时的卒中严重程度降低独立相关。
