The Efficacy of Intensive Statin Therapy in Acute Ischemic Stroke Following Intravenous Thrombolysis: The CASE II Study.

AIMS

This study aimed to investigate the efficacy of early intensive statin therapy following intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS).

METHODS

AIS patients who received IVT and statin therapy were included from multicenter registry databases. The primary endpoint was functional independence, defined by a modified Rankin Scale (mRS) score of 0-2 at 90 days. Propensity score matching (PSM) analyses were employed.

RESULTS

A total of 21,349 patients were included in this study, with a mean age of 68.5 ± 12.6 years, of whom 13,578 (63.6%) were male. The baseline NIHSS score was 4 (IQR 2-8). A total of 9532 patients (44.6%) received intensive statin therapy. In the PSM analysis, the proportion of patients with mRS scores of 0-2 was significantly higher in the intensive statin therapy group (OR = 1.095, 95% CI 1.022-1.173, p = 0.010). Statin type modified the effect of intensive statin therapy on functional independence (p-value for interaction = 0.030). Treatment effects favoring the intensive approach were observed in patients receiving atorvastatin (OR = 1.134, 95% CI 1.051-1.224, p = 0.001).

CONCLUSION

Early intensive statin therapy following IVT leads to a significant but modest improvement in neurological outcomes, particularly in patients treated with atorvastatin as part of the intensive regimen.