Statin pretreatment combined with intravenous thrombolysis for ischemic stroke patients: A meta-analysis

Abstract

Purpose: For ischemic stroke patients, thrombolysis therapy combined statins might have a better benefit. But difference studies had a debate. The meta-analysis wants to make clear about whether statins could increase effect of therapy or decrease side effect for these patients.

Methods objectives: To evaluate the effect and safety about using statins in ischemic stroke patients receiving thrombolysis.

Data sources: Databases including PubMed, Web of Science, Embase and Cochrane Library.

Eligibility criteria: original observational cohort studies.

Participants: ischemic stroke patients receiving thrombolysis.

Interventions: pretreatment statins.

Appraisal and synthesis methods: forest plot to show pooled results; I-squared test to evaluate the heterogeneity.

Results: Of 87 selected, 8 were eligible. The 8 studies included 10,344 patients (with statins: 2048; without statins: 8296). For clinical recovery at 24 h, pooled OR (odds ratios) was 1.82 (95% CI: 1.49-2.21). For excellent outcome, pooled OR was 1.03 (95% CI: 0.80-1.12). For favorable outcome, pooled OR was 0.99 (95% CI: 0.85-1.16). For ICH (intracranial hemorrhage), pooled OR was 1.16 (95% CI: 0.97-1.40). For sICH (symptomatic intracranial hemorrhage), pooled OR was 1.40 (95% CI: 1.02-1.91). For mortality, overall pooled OR was 0.96 (95% CI: 0.74-1.25).

Conclusion: In conclusion, the meta-analysis found that for ischemic stroke patients receiving thrombolysis, pretreatment statins were related to a better clinical recovery and a lower short-term mortality. Pretreatment statins had no significant relationship with mRS at 90 days and ICH. Pretreatment high dose statins may be related to the occurrence of sICH.

Keywords: Clinical recovery; Intravenous thrombolysis; Statins; Stroke; sICH.