• Je něco špatně v tomto záznamu ?

Association of statin pre-treatment with baseline stroke severity and outcome in patients with acute ischemic stroke and received reperfusion treatment: An observational study

I. Escudero-Martínez, M. Matusevicius, A. Pavia-Nunes, P. Sevcik, M. Nevsimalova, VM. Rand, J. Kõrv, M. Cappellari, R. Mikulik, D. Toni, N. Ahmed

. 2023 ; 18 (2) : 201-207. [pub] 20220511

Jazyk angličtina Země Spojené státy americké

Typ dokumentu pozorovací studie, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc23004469

BACKGROUND: Statins have an important role in stroke prevention, especially in high-risk populations and may also affect the initial stroke severity and outcomes in patients taking them before an ischemic stroke. AIMS: Our aim was to evaluate the association of statin pre-treatment with the severity in acute ischemic stroke (AIS). METHODS: We analyzed AIS patients received intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT) and recorded in the SITS International Thrombolysis and Thrombectomy Registry from 2011 to 2017. We identified patients with statin information at baseline. The primary outcome was baseline National Institutes of Health Stroke Scale (NIHSS) score. Secondary outcomes were NIHSS score at 24 h, symptomatic intracerebral hemorrhage (SICH) and functional outcome at 90 days after acute intervention. Multivariable linear and logistic regression and propensity score matching (PSM) was used to quantify the effect of statin pre-treatment. RESULTS: Of 93,849 patients, 23,651 (25.2%) were treated with statins prior the AIS. Statin pre-treatment group was older and had higher comorbidity. Median NIHSS at baseline was similar between groups. In the adjusted and PSM analysis, statin pre-treatment was inversely associated with baseline NIHSS (odds ratio (OR) = 0.77, 95% confidence interval (CI) = 0.6-0.99 and OR for PSM 0.73, 95% CI = 0.54-0.99, p = 0.004) and independently associated with mild stroke defined as NIHSS ⩽8 in adjusted and PSM analysis (OR = 1.21, 95% CI = 1.1-1.34, p < 0.001 and OR for PSM 1.17, 95% CI = 1.05-1.31, p = 0.007). Regarding secondary outcomes, there were no differences in functional outcomes, death nor SICH rates between groups. CONCLUSION: Prior treatment with statins was associated with lower NIHSS at baseline. However, this association did not translate into any difference regarding functional outcome at 90 days. No association was found regarding SICH. These findings indicate the need of further studies to assess the effect on statin pre-treatment on initial stroke severity.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc23004469
003      
CZ-PrNML
005      
20230425141426.0
007      
ta
008      
230418s2023 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1177/17474930221095965 $2 doi
035    __
$a (PubMed)35403505
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Escudero-Martínez, Irene $u Department of Neurology, Hospital Universitari Politècnic La Fe, Valencia, Spain $u Neurovascular Research Laboratory, Instituto Biomedicina Sevilla-IBiS, Sevilla, Spain $1 https://orcid.org/0000000318380235
245    10
$a Association of statin pre-treatment with baseline stroke severity and outcome in patients with acute ischemic stroke and received reperfusion treatment: An observational study / $c I. Escudero-Martínez, M. Matusevicius, A. Pavia-Nunes, P. Sevcik, M. Nevsimalova, VM. Rand, J. Kõrv, M. Cappellari, R. Mikulik, D. Toni, N. Ahmed
520    9_
$a BACKGROUND: Statins have an important role in stroke prevention, especially in high-risk populations and may also affect the initial stroke severity and outcomes in patients taking them before an ischemic stroke. AIMS: Our aim was to evaluate the association of statin pre-treatment with the severity in acute ischemic stroke (AIS). METHODS: We analyzed AIS patients received intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT) and recorded in the SITS International Thrombolysis and Thrombectomy Registry from 2011 to 2017. We identified patients with statin information at baseline. The primary outcome was baseline National Institutes of Health Stroke Scale (NIHSS) score. Secondary outcomes were NIHSS score at 24 h, symptomatic intracerebral hemorrhage (SICH) and functional outcome at 90 days after acute intervention. Multivariable linear and logistic regression and propensity score matching (PSM) was used to quantify the effect of statin pre-treatment. RESULTS: Of 93,849 patients, 23,651 (25.2%) were treated with statins prior the AIS. Statin pre-treatment group was older and had higher comorbidity. Median NIHSS at baseline was similar between groups. In the adjusted and PSM analysis, statin pre-treatment was inversely associated with baseline NIHSS (odds ratio (OR) = 0.77, 95% confidence interval (CI) = 0.6-0.99 and OR for PSM 0.73, 95% CI = 0.54-0.99, p = 0.004) and independently associated with mild stroke defined as NIHSS ⩽8 in adjusted and PSM analysis (OR = 1.21, 95% CI = 1.1-1.34, p < 0.001 and OR for PSM 1.17, 95% CI = 1.05-1.31, p = 0.007). Regarding secondary outcomes, there were no differences in functional outcomes, death nor SICH rates between groups. CONCLUSION: Prior treatment with statins was associated with lower NIHSS at baseline. However, this association did not translate into any difference regarding functional outcome at 90 days. No association was found regarding SICH. These findings indicate the need of further studies to assess the effect on statin pre-treatment on initial stroke severity.
650    _2
$a lidé $7 D006801
650    12
$a cévní mozková příhoda $x farmakoterapie $x komplikace $7 D020521
650    12
$a statiny $x terapeutické užití $x škodlivé účinky $7 D019161
650    12
$a ischemická cévní mozková příhoda $x farmakoterapie $7 D000083242
650    12
$a ischemie mozku $x farmakoterapie $x komplikace $7 D002545
650    _2
$a výsledek terapie $7 D016896
650    _2
$a cerebrální krvácení $x komplikace $7 D002543
650    _2
$a trombolytická terapie $x škodlivé účinky $7 D015912
650    12
$a endovaskulární výkony $7 D057510
655    _2
$a pozorovací studie $7 D064888
655    _2
$a časopisecké články $7 D016428
700    1_
$a Matusevicius, Marius $u Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden $u Department of Neurology, Karolinska University Hospital, Stockholm, Sweden $1 https://orcid.org/000000022868127X
700    1_
$a Pavia-Nunes, Ana $u Stroke Unit, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
700    1_
$a Sevcik, Petr $u Department of Neurology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic $1 https://orcid.org/0000000253097446
700    1_
$a Nevsimalova, Miroslava $u Department of Neurology, Comprehensive Cerebrovascular Center, Hospital Ceske Budejovice, České Budějovice, Czech Republic
700    1_
$a Rand, Viiu-Marika $u Department of Neurology, North Estonia Medical Centre Foundation, Tallinn, Estonia $1 https://orcid.org/0000000180594192
700    1_
$a Kõrv, Janika $u Institute of Clinical Medicine, Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia $1 https://orcid.org/0000000260740727
700    1_
$a Cappellari, Manuel $u Stroke Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy $1 https://orcid.org/0000000235343201
700    1_
$a Mikulik, Robert $u International Clinical Research Center and Department of Neurology, St. Anne's University Hospital and Faculty of Medicine at Masaryk University, Brno, Czech Republic
700    1_
$a Toni, Danilo $u Department of Human Neurosciences, University La Sapienza Rome, Rome, Italy
700    1_
$a Ahmed, Niaz $u Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden $u Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
773    0_
$w MED00176295 $t International journal of stroke : official journal of the International Stroke Society $x 1747-4949 $g Roč. 18, č. 2 (2023), s. 201-207
856    41
$u https://pubmed.ncbi.nlm.nih.gov/35403505 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20230418 $b ABA008
991    __
$a 20230425141422 $b ABA008
999    __
$a ok $b bmc $g 1924893 $s 1190678
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2023 $b 18 $c 2 $d 201-207 $e 20220511 $i 1747-4949 $m International journal of stroke $n Int J Stroke $x MED00176295
LZP    __
$a Pubmed-20230418

Najít záznam

Citační ukazatele

Možnosti archivace