Wang Ke-Wu, Feng Chao, Wu Yin-Fei, Huang Jing, Xiao Wen-Bo, Xia Shu-Dong
Department of Radiology, the Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China.
Department of Cardiology, the Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China; Department of Neurology, Shanghai Tenth People's Hospital of Tongji University School of Medicine, Shanghai, China.
J Stroke Cerebrovasc Dis. 2020 May;29(5):104697. doi: 10.1016/j.jstrokecerebrovasdis.2020.104697. Epub 2020 Feb 21.
Myocardial injury is a complication of stroke associated with unfavorable outcome, with the elevation of cardiac troponin as the most sensitive marker. In this study, we aimed at investigating the association between statin pretreatment and poststroke myocardial injury.
Six hundred seventy-one patients diagnosed as acute ischemic stroke were enrolled. According to the histories of statin pretreatment before stroke, patients were categorized into nonstatin (n = 474) and statin groups (n = 197), with the latter further divided into low-dosage, standard-dosage, and high-dosage subgroups according the dosages of statins. The level of troponin-T was tested and troponin-T level ≥14 ng/l was identified to indicate the presence of myocardial injury. The level of troponin-T and the prevalence of myocardial injury was compared between groups. Logistic regression was used to identify the effect of statin pretreatment for the presence of post-stroke myocardial injury.
Statin users had lower levels of troponin-T after stroke, with the level of troponin-T being the lowest in the high-dosage subgroup. The results of logistic regression showed that statin pretreatment and high-dosage statin were independent protective factors for the elevation of troponin-T levels.
Statin pretreatment might be associated with the decreased myocardial injury after ischemic stroke.
心肌损伤是卒中的一种并发症，与不良预后相关，心肌肌钙蛋白升高是最敏感的标志物。在本研究中，我们旨在调查他汀类药物预处理与卒中后心肌损伤之间的关联。
纳入671例诊断为急性缺血性卒中的患者。根据卒中前他汀类药物预处理史，患者分为非他汀组（n = 474）和他汀组（n = 197），后者根据他汀类药物剂量进一步分为低剂量、标准剂量和高剂量亚组。检测肌钙蛋白-T水平，肌钙蛋白-T水平≥14 ng/l被确定为存在心肌损伤。比较各组间肌钙蛋白-T水平和心肌损伤患病率。采用逻辑回归分析确定他汀类药物预处理对卒中后心肌损伤存在与否的影响。
使用他汀类药物的患者卒中后肌钙蛋白-T水平较低，高剂量亚组的肌钙蛋白-T水平最低。逻辑回归结果显示，他汀类药物预处理和高剂量他汀是肌钙蛋白-T水平升高的独立保护因素。
他汀类药物预处理可能与缺血性卒中后心肌损伤减少有关。
