The beneficial effect of statins treatment by stroke subtype
The beneficial effect of statins treatment by stroke subtype
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DOI：
10.1111/j.1468-1331.2008.02370.x
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发表时间：
2009-01-01
影响因子：
5.1
通讯作者：
Diez-Tejedor, E.
中科院分区：
文献类型：
--
作者：
Martinez-Sanchez, P.;Rivera-Ordonez, C.;Diez-Tejedor, E.
在观察性研究中，他汀类药物在缺血性卒中后显示出一定的保护作用。然而，这种影响从未被病原学亚型评估过。观察性研究使用连续脑梗死患者卒中单位数据库的数据。分析的变量：人口统计数据、心血管危险因素、中风发病时他汀类药物的治疗、中风严重程度、中风亚型、住院并发症、住院时间和出院时的功能状态（修正Rankin量表）。共纳入2742例患者，其中男性1539例。平均年龄69.17岁（SD 12.19）。其中，281名患者（10.2%）在入院时接受他汀类药物治疗。logistic回归分析显示，在调整人口统计数据、危险因素、既往治疗、卒中亚型、卒中严重程度、住院并发症和住院时间后，既往接受他汀类药物治疗是所有卒中（OR, 2.08; 95% CI， 1.39至3.1）以及动脉粥样硬化血栓性卒中（OR, 2.79; 95% CI， 1.33至5.84）和腔隙性卒中（OR, 2.28; 95% CI， 1.15至4.52）出院时预后较好的独立预测因子。这种益处在心栓塞性或其他病因性中风中均未观察到。既往他汀类药物治疗是缺血性卒中患者预后良好的独立因素。动脉粥样硬化性血栓和小血管中风显示出最大的益处。
Statins have shown some protective effect after ischaemic stroke in observational studies. However, this effect has never been assessed by etiological subtypes.Observational study using data from the Stroke Unit Data Bank from consecutive patients with cerebral infarction. Variables analyzed: demographic data, cardiovascular risk factors, treatment with statins at stroke onset, stroke severity, stroke subtype, in-hospital complications, length of stay, and functional status at discharge (modified Rankin Scale).A total of 2742 patients were included, 1539 were men. Mean age was 69.17 years (SD 12.19). Of these, 281 patients (10.2%) were receiving statins when admitted. The logistic regression analyses showed that previous treatment with statins was an independent predictor for better outcome at discharge among all strokes (OR, 2.08; 95% CI, 1.39 to 3.1) as well as for the atherothrombotic (OR, 2.79; 95% CI, 1.33 to 5.84) and lacunar strokes (OR, 2.28; 95% CI, 1.15 to 4.52) after adjustment for demographic data, risk factors, previous treatments, stroke subtypes, stroke severity, in-hospital complications and length of stay. This benefit was not observed either in cardioembolic or in other etiology strokes.Previous treatment with statins is an independent factor associated with good outcomes in patients with ischaemic stroke. Atherothrombotic and small vessel strokes show the greatest benefit.