Department of Rehabilitation, Liuzhou Municipal Liutie Central Hospital, Liunan Distract, Liuzhou, Guangxi, China.
Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
J Clin Neurosci. 2022 Sep;103:124-130. doi: 10.1016/j.jocn.2022.07.001. Epub 2022 Jul 19.
High-dose statins are recommended as preventive drugs in guidelines for patients with ischaemic stroke undergoing thrombectomy. Not only in clinical practice but also based on large-scale studies, low-dose statins have been widely used and demonstrated to be efficient in Asian populations. However, it remains unknown whether a low-dose statin is related to the prognosis of patients with thrombectomy. Can low-dose statins reduce the risk of bleeding at the same time?
We prospectively collected data from patients with acute ischaemic stroke undergoing intra-arterial thrombectomy. Efficacy outcomes were National Institutes of Health Stroke Scale (NIHSS) score improvement at 7 days after admission and a favourable functional outcome (FFO) at 90 days. Safety outcomes were rates of in-hospital haemorrhage events and death within 2 years.
We included 256 patients in this study. Compared with the control group, the low-dose statin group had a higher NIHSS improvement rate at 7 days, a higher FFO rate at 90 days and a lower death rate within 2 years. The low-dose statin group had a lower percentage of gastrointestinal haemorrhage. Statin use was significantly related to an improved NIHSS score (p = 0.028, OR = 1.773) at 7 days and FFO (P < 0.001, OR = 2.962) at 90 days and to lower death rates (P = 0.025, or = 0.554) within 2 years.
In Asian acute ischaemic stroke patients with intra-arterial thrombectomy, low-dose statin use was significantly related to NIHSS improvement at 7 days, FFO at 90 days and decreased death rates within 2 years.
高剂量他汀类药物被推荐为接受血栓切除术的缺血性脑卒中患者的预防药物。不仅在临床实践中,而且基于大规模研究,低剂量他汀类药物已被广泛应用,并被证明在亚洲人群中有效。然而,低剂量他汀类药物是否与接受血栓切除术的患者的预后有关尚不清楚。同时,低剂量他汀类药物是否可以降低出血风险?
我们前瞻性地收集了接受动脉内血栓切除术的急性缺血性脑卒中患者的数据。疗效终点为入院后 7 天 NIHSS 评分改善和 90 天良好功能结局(FFO)。安全性终点为院内出血事件发生率和 2 年内死亡率。
本研究共纳入 256 例患者。与对照组相比,低剂量他汀组在 7 天 NIHSS 改善率更高,90 天 FFO 率更高,2 年内死亡率更低。低剂量他汀组胃肠道出血比例较低。他汀类药物的使用与入院后 7 天 NIHSS 评分的改善显著相关(p = 0.028,OR = 1.773)和 90 天 FFO(P < 0.001,OR = 2.962)以及 2 年内死亡率降低(P = 0.025,OR = 0.554)显著相关。
在亚洲接受动脉内血栓切除术的急性缺血性脑卒中患者中,低剂量他汀类药物的使用与入院后 7 天 NIHSS 评分的改善、90 天 FFO 和 2 年内死亡率降低显著相关。