Lee Sang-Hwa, Jang Min Uk, Kim Yerim, Park So Young, Kim Chulho, Kim Yeo Jin, Sohn Jong-Hee
Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.
Institute of New Frontier Research, Hallym University, Chuncheon 24252, Korea.
J Clin Med. 2021 Nov 2;10(21):5147. doi: 10.3390/jcm10215147.
We evaluated the impact of prior statin use on successful reperfusion and stroke outcomes after endovascular treatment (EVT).
Using consecutive multicenter databases, we enrolled acute ischemic stroke patients receiving EVT between 2015 and 2021. Patients were classified into prior statin users and no prior statin users after a review of premorbid medications. The primary outcome measure was successful reperfusion defined as modified TICI grade 2b or 3 after EVT. Secondary outcome measures were early neurologic deterioration (END) and a 3-month modified Rankin Scale (mRS) score of 0 to 2.
Among 385 patients receiving EVT, 74 (19.2%) were prior statin users, who had a significantly higher successful reperfusion rate compared with no prior statin users (94.6% versus 78.8%, = 0.002). Successful reperfusion and END occurrence were improved according to statin intensity with a dose-response relationship. In multivariate analysis, prior statin was associated with successful reperfusion after EVT (adjusted odds ratio (95% confidence interval) 5.31 (1.67-16.86)). In addition, prior statin was associated with a lower occurrence of END and good functional status.
Our study showed that prior statin use before ischemic stroke might improve successful reperfusion and stroke outcomes after EVT.
我们评估了既往使用他汀类药物对血管内治疗（EVT）后成功再灌注及卒中结局的影响。
利用连续多中心数据库，我们纳入了2015年至2021年间接受EVT的急性缺血性卒中患者。在回顾病前用药情况后，将患者分为既往使用他汀类药物者和未使用他汀类药物者。主要结局指标为成功再灌注，定义为EVT后改良脑梗死溶栓分级（TICI）2b级或3级。次要结局指标为早期神经功能恶化（END）和3个月改良Rankin量表（mRS）评分为0至2分。
在385例接受EVT的患者中，74例（19.2%）为既往使用他汀类药物者，与未使用他汀类药物者相比，其成功再灌注率显著更高（94.6%对78.8%，P = 0.002）。根据他汀类药物强度，成功再灌注和END的发生率有所改善，呈剂量反应关系。在多变量分析中，既往使用他汀类药物与EVT后成功再灌注相关（调整后的优势比（95%置信区间）为5.31（1.67 - 16.86））。此外，既往使用他汀类药物与END发生率较低及良好的功能状态相关。
我们的研究表明，缺血性卒中前使用他汀类药物可能会改善EVT后的成功再灌注及卒中结局。
