Statin pretreatment combined with intravenous thrombolysis for ischemic stroke patients: A meta-analysis.

PURPOSE

For ischemic stroke patients, thrombolysis therapy combined statins might have a better benefit. But difference studies had a debate. The meta-analysis wants to make clear about whether statins could increase effect of therapy or decrease side effect for these patients.

METHODS OBJECTIVES

To evaluate the effect and safety about using statins in ischemic stroke patients receiving thrombolysis.

DATA SOURCES

Databases including PubMed, Web of Science, Embase and Cochrane Library.

ELIGIBILITY CRITERIA

original observational cohort studies.

PARTICIPANTS

ischemic stroke patients receiving thrombolysis.

INTERVENTIONS

pretreatment statins.

APPRAISAL AND SYNTHESIS METHODS

forest plot to show pooled results; I-squared test to evaluate the heterogeneity.

RESULTS

Of 87 selected, 8 were eligible. The 8 studies included 10,344 patients (with statins: 2048; without statins: 8296). For clinical recovery at 24 h, pooled OR (odds ratios) was 1.82 (95% CI: 1.49-2.21). For excellent outcome, pooled OR was 1.03 (95% CI: 0.80-1.12). For favorable outcome, pooled OR was 0.99 (95% CI: 0.85-1.16). For ICH (intracranial hemorrhage), pooled OR was 1.16 (95% CI: 0.97-1.40). For sICH (symptomatic intracranial hemorrhage), pooled OR was 1.40 (95% CI: 1.02-1.91). For mortality, overall pooled OR was 0.96 (95% CI: 0.74-1.25).

CONCLUSION

In conclusion, the meta-analysis found that for ischemic stroke patients receiving thrombolysis, pretreatment statins were related to a better clinical recovery and a lower short-term mortality. Pretreatment statins had no significant relationship with mRS at 90 days and ICH. Pretreatment high dose statins may be related to the occurrence of sICH.