医学
溶栓
改良兰金量表
他汀类
内科学
冲程(发动机)
心房颤动
优势比
倾向得分匹配
脑出血
心脏病学
缺血性中风
心肌梗塞
缺血
蛛网膜下腔出血
工程类
机械工程
作者
Ashkan Mowla,Harshit Shah,Navdeep Lail,Caila Vaughn,Peyman Shirani,Robert N. Sawyer
出处
期刊:Cerebrovascular Diseases
[S. Karger AG]
日期:2020-01-01
卷期号:49 (5): 503-508
被引量:14
摘要
<b><i>Aim:</i></b> The aim of this was to study the effects of statins and their intensity on symptomatic intracranial hemorrhage (sICH) and outcome after IV thrombolysis (IVT) for acute ischemic stroke (AIS). <b><i>Methods:</i></b> We retrospectively reviewed the medical records and cerebrovascular images of all the patients treated with IVT for AIS in our center in a 10-year period. Patients were further characterized as any statin users versus non-users on admission to the emergency department. Statins were categorized in high intensity or low intensity statin based on its propensity to reduce lower low-density cholesterol by ≥45% or <45%, respectively. Safety and discharge modified Rankin Score were compared between statin users versus non-users and also between high-intensity versus low-intensity groups. <b><i>Results:</i></b> A total of 834 patients received IVT for AIS in our center during a 10-year period. Multivariate models were adjusted for age, NIH Stroke Scale at admission, INR, and history of DM and atrial fibrillation. There was no association between odds of sICH and any statin use (OR = 0.52 [0.26–1.03], <i>p</i> = 0.06). In multivariate model, any statin use was not associated with odds of poor outcome (Table 4: OR = 1.01 [0.79–1.55], <i>p</i> = 0.57). There was no significant association between odds of sICH among patients on high-intensity statin compared to low intensity statin (multivariate model OR = 0.39 [0.11–1.40], <i>p</i> = 0.15). There was 47% reduced odds of poor outcome among patients on high-intensity statin as compared to low-intensity statin (OR = 0.53[0.32–0.88] <i>p</i> = 0.01). However, this significant association was lost in the multivariate model (OR = 0.60 [0.35–1.05], <i>p</i> = 0.07). <b><i>Conclusion:</i></b> Our study does not show any significant association between risk of sICH and poor outcome after IVT for patients on prior statin therapy. We also did not find significant association between the risk of sICH and poor outcome after IVT and the intensity of the stain used.
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