Low-dose statin pretreatment improves function and prognosis of recurrent ischemic stroke patients
Low-dose statin pretreatment improves function and prognosis of recurrent ischemic stroke patients
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小剂量他汀类药物预处理改善复发性缺血性脑卒中患者的功能和预后
DOI：
10.1177/1756286420920078
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发表时间：
2020-06-01
影响因子：
5.9
通讯作者：
He, Li
中科院分区：
文献类型：
--
作者：
Cui, Chaohua;Dong, Shuju;He, Li
背景：他汀类药物可有效改善脑卒中患者的预后。在临床实践中，低剂量他汀类药物常用于亚洲国家的脑卒中患者，但其对复发性缺血性脑卒中患者预后的影响尚不清楚。方法：前瞻性收集连续复发性缺血性脑卒中患者的资料。采用美国国立卫生研究院卒中量表（NIHSS）和改良兰金量表（mRs）评定患者入院和出院时的主要转归。次要结局包括亚组分析。结果：219例患者（平均年龄65.41 ± 11.58岁）中，150例（68.5%）为男性。低剂量他汀类药物组在入院（p < 0.001）和出院（p < 0.001）时轻度卒中的比例较高，90天时功能结局良好（p < 0.001）。单变量回归分析显示，使用低剂量他汀类药物与出院时NIHSS较高[比值比（OR）= 0.36，p = 0.009]和90天时mRs较高（OR = 0.230，p < 0.001）呈负相关。多变量logistic回归分析显示，低剂量他汀类药物也与90天时较高的mRs显著负相关（OR = 0.098，p = 0.049）。根据亚组分析，在良好持续性亚组中发现了显著效应（出院时NIHSS评分：OR = 0.051，p = 0.004; 3个月时mRs评分：OR = 0.053，p = 0.005），但在较差持续性亚组中未发现显著效应。结论：小剂量他汀类药物预处理可减轻复发性脑卒中患者的卒中严重程度，改善功能结局。
Background: Statins are effective in improving the prognosis of stroke patients. In clinical practice, low-dose statins are often administered to stroke patients in Asian countries but their effects on the prognosis of recurrent ischemic stroke patients are still unclear. Methods: Data of consecutive recurrent ischemic stroke patients were prospectively collected. The National Institutes of Health Stroke Scale (NIHSS) of admission and discharge and the modified Rankin scale (mRs) of 90 days after stroke onset were adopted to evaluate primary outcomes. Secondary outcomes included the subgroup analysis. Results: Among 219 patients (mean age 65.41 ± 11.58 years), 150 (68.5%) were male. The low-dose statin group had a higher percentage of milder stroke at admission (p < 0.001) and discharge (p < 0.001), and favorable functional outcome at 90 days (p < 0.001). Univariable regression analysis showed that the use of low-dose statins was inversely associated with higher discharge NIHSS [odds ratio (OR) = 0.36, p = 0.009] and higher mRs at 90 days (OR = 0.230, p < 0.001). Multivariable logistic regression analysis revealed that low-dose statins also had a significantly inverse association with higher mRs at 90 days (OR = 0.098, p = 0.049). According to subgroup analysis, a significant effect was found in the good-persistency subgroup (NIHSS score at discharge: OR = 0.051, p = 0.004; mRs score at 3 months: OR = 0.053, p = 0.005), but not in the poor-persistency subgroup. Conclusion: Low-dose statin pretreatment alleviated stroke severity and improved functional outcomes of recurrent stroke patients.