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. 2019 Mar;15(2):385-392.
doi: 10.5114/aoms.2019.82925. Epub 2019 Mar 4.

Beneficial effects of pre-stroke statins use in cardioembolic stroke patients with atrial fibrillation: a hospital-based retrospective analysis

Dariusz Kotlęga  1 , Monika Gołąb-Janowska  1 , Agnieszka Meller  1 , Anna Bajer-Czajkowska  1 , Agnieszka Zembroń-Łacny  2 , Przemysław Nowacki  1 , Maciej Banach  3
Affiliations

Beneficial effects of pre-stroke statins use in cardioembolic stroke patients with atrial fibrillation: a hospital-based retrospective analysis

Dariusz Kotlęga et al. Arch Med Sci. 2019 Mar.

Abstract

Introduction: Statins are widely used in stroke patients. The AHA/ASA guidelines recommend aggressive statin therapy in atherosclerotic stroke patients. Their beneficial effects are due to both their hypolipemic and pleiotropic properties. The aim of this study was to establish potential benefits from statin use in ischemic stroke patients with the diagnosis of atrial fibrillation (AF).

Material and methods: Ischemic stroke patients with AF were enrolled in the study. Group I, the statin group (n = 181), consisted of patients who had been treated with statins before stroke. Group II, the non-statin group (n = 153), consisted of patients who had not received such treatment in the last year. In-hospital mortality and neurological deficit on admission and at discharge were analyzed using the National Institutes of Health Stroke Scale (NIHSS) score.

Results: Patients from the non-statin group had greater initial and discharge NIHSS scores (10 vs. 11.9, probability value p < 0.05; 7.6 vs. 9.5, p < 0.05 respectively). The improvement in NIHSS score was greater in the statin group (73.5% vs. 59.5%, p < 0.01). In-hospital mortality was more frequent in the non-statin group (9.9% vs. 18.3%, p < 0.05).

Conclusions: Despite the predominant use of statins in atherothrombotic stroke patients, we demonstrated the beneficial effects of statins in cardioembolic stroke patients. Detailed cardiovascular screening for statin therapy should be carried out in all AF patients with regard to primary and secondary stroke prevention.

Keywords: anticoagulant prophylaxis; atrial fibrillation; embolism; outcome; statin; stroke.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Intrahospital recovery after stroke in AF patients treated with statins before stroke onset. Recovery: group I vs. group II, p = 0.0067; no change: group I vs. group II, p = 0.0074; worsening: group I vs. group II, p = 0.7666
Figure 2
Figure 2
Significantly more frequent death in AF patients not treated with statins before stroke onset (group I vs. group II; p = 0.0203)
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