scholarly journals Early statin therapy reduces all-cause mortality in acute hemorrhagic stroke patients without prior statin use

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P384-P384
Author(s):  
P.- S. Chen ◽  
Y.- H. Li ◽  
C.- L. Chang ◽  
Y.- H. Kao Yang
Keyword(s):  
Statin Therapy ◽  
Hemorrhagic Stroke ◽  
Stroke Patients ◽  
All Cause Mortality ◽  
Acute Hemorrhagic Stroke ◽  
Statin Use

Abstract 9: Clinical Effectiveness of Statin Therapy after Ischemic Stroke: Primary Results from the PROSPER Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Emily C O'Brien ◽  
Melissa A Greiner ◽  
Ying Xian ◽  
Gregg C Fonarow ◽  
DaiWai M Olson ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Statin Therapy ◽  
Real World ◽  
Hemorrhagic Stroke ◽  
World Population ◽  
Stroke Patients ◽  
Post Discharge ◽  
All Cause Mortality ◽  
Lower Hazard ◽  
Statin Use

Background: Evidence for statin use comes primarily from select clinical trial populations that are often younger without comorbidities. Stroke patients and their caregivers are in need of real-world effectiveness data to better inform decision-making on statin use after stroke. Methods: PROSPER is a PCORI-funded research program designed with stroke survivors to evaluate the effectiveness of therapies post-stroke. We linked data from Get With The Guidelines-Stroke patients >65 years of age to Medicare claims to capture post-discharge outcomes. Primary outcomes prioritized by patients were: 1) Home time (days alive and out of acute or post-acute care) and 2) Major adverse cardiovascular events (MACE). Secondary outcomes included all-cause mortality, all-cause readmission, CV readmission, and hemorrhagic stroke. We used negative binomial and Cox models to evaluate discharge statins and outcomes with inverse probability weighting (IPW) to adjust for baseline differences by treatment group. Results: Of 77,468 statin-naïve ischemic stroke patients hospitalized from 2007-2011, n=54,991 (71%) were discharged on statin therapy. Compared with those not receiving a statin, patients receiving a statin were younger and more likely to be smokers. Unadjusted rates of MACE, mortality and CV readmission within 2 years were lower for statin patients compared with those not receiving a statin. After IPW adjustment, statin therapy was associated with 28 more days of home time in the 2-year post-discharge period (P <.001), 9% lower hazard of MACE (P <.001), 16% lower hazard of mortality (P <.001), and 7% lower hazard of readmission (P <.001). Statin use was not associated with increased risk of hemorrhagic stroke (P=0.56). Conclusions: In a real-world population of older statin-naïve ischemic stroke patients, discharge statin therapy was associated with more days spent at home during the 2-year period after hospitalization and lower risk of both MACE and all-cause mortality.

Prestroke statin use enhances collateralization in acute ischemic stroke patients

2020 ◽  
Vol 38 (4) ◽  
pp. 311-321
Author(s):  
Jiaying Zhu ◽  
Mengmeng Ma ◽  
Jinghuan Fang ◽  
Jiajia Bao ◽  
Shuju Dong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Acute Ischemic Stroke ◽  
Statin Therapy ◽  
Cerebral Artery ◽  
Functional Outcomes ◽  
Collateral Circulation ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Statin Use

Background: Statin therapy has been shown to be effective in the prevention of ischemic stroke. In addition, recent studies have suggested that prior statin therapy could lower the initial stroke severity and improve stroke functional outcomes in the event of stroke. It was speculated that prestroke statin use may enhance collateral circulation and result in favorable functional outcomes. Objective: The aim of the study was to investigate the association of prestroke statin use with leptomeningeal collaterals and to determine the association of prestroke statin use with stroke severity and functional outcome in acute ischemic stroke patients. Methods: We prospectively and consecutively enrolled 239 acute ischemic stroke patients with acute infarction due to occlusion of the middle cerebral artery within 24 h in the neurology department of West China Hospital from May 2011 to April 2017. Computed tomographic angiography (CTA) imaging was performed for all patients to detect middle cerebral artery thrombus; regional leptomeningeal collateral score (rLMCS) was used to assess the degree of collateral circulation; the National Institutes of Health Stroke Scale (NIHSS) was used to measure stroke severity at admission; the modified Rankin scale (mRS) was used to measure outcome at 90 days; and premorbid medications were recorded. Univariate and multivariate analyses were performed. Results: Overall, 239 patients met the inclusion criteria. Fifty-four patients used statins, and 185 did not use statins before stroke onset. Prestroke statin use was independently associated with good collateral circulation (rLMCS > 10) (odds ratio [OR], 4.786; 95% confidence interval [CI], 1.195–19.171; P = 0.027). Prestroke statin use was not independently associated with lower stroke severity (NIHSS score≤14) (OR, 1.955; 95% CI, 0.657–5.816; p = 0.228), but prestroke statin use was independently associated with favorable outcome (mRS score≤2) (OR, 3.868; 95% CI, 1.325–11.289; P = 0.013). Conclusions: Our findings suggest that prestroke statin use was associated with good leptomeningeal collaterals and clinical outcomes in acute ischemic stroke (AIS) patients presenting with occlusion of the middle cerebral artery. However, clinical studies should be conducted to verify this claim.

The Patterns of Antihypertensive Drugs use in Acute Hemorrhagic Stroke Patients

2020 ◽  
Vol 13 (2) ◽  
pp. 547
Author(s):  
Din Amalia Widyaningrum ◽  
Wenny Putri Nilamsari ◽  
Wardah Rahmatul Islamiyah ◽  
Dewi Wara Shinta
Keyword(s):  
Hemorrhagic Stroke ◽  
Antihypertensive Drugs ◽  
Stroke Patients ◽  
Acute Hemorrhagic Stroke

scholarly journals Improved COVID-19 Outcomes following Statin Therapy: An Updated Systematic Review and Meta-analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-20
Author(s):  
Amir Vahedian-Azimi ◽  
Seyede Momeneh Mohammadi ◽  
Maciej Banach ◽  
Farshad Heidari Beni ◽  
Paul C. Guest ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Statin Therapy ◽  
Disease Transmission ◽  
Statistical Power ◽  
Meta Analysis ◽  
Random Effect ◽  
Statin Treatment ◽  
Icu Admission ◽  
All Cause Mortality ◽  
Statin Use

Background. Although vaccine rollout for COVID-19 has been effective in some countries, there is still an urgent need to reduce disease transmission and severity. We recently carried out a meta-analysis and found that pre- and in-hospital use of statins may improve COVID-19 mortality outcomes. Here, we provide an updated meta-analysis in an attempt to validate these results and increase the statistical power of these potentially important findings. Methods. The meta-analysis investigated the effect of observational and randomized clinical studies on intensive care unit (ICU) admission, tracheal intubation, and death outcomes in COVID-19 cases involving statin treatment, by searching the scientific literature up to April 23, 2021. Statistical analysis and random effect modeling were performed to assess the combined effects of the updated and previous findings on the outcome measures. Findings. The updated literature search led to the identification of 23 additional studies on statin use in COVID-19 patients. Analysis of the combined studies ( n = 47 ; 3,238,508 subjects) showed no significant effect of statin treatment on ICU admission and all-cause mortality but a significant reduction in tracheal intubation ( OR = 0.73 , 95% CI: 0.54-0.99, p = 0.04 , n = 10 studies). The further analysis showed that death outcomes were significantly reduced in the patients who received statins during hospitalization ( OR = 0.54 , 95% CI: 0.50-0.58, p < 0.001 , n = 7 studies), with no such effect of statin therapy before hospital admission ( OR = 1.06 , 95% CI = 0.82 -1.37, p = 0.670 , n = 29 studies). Conclusion. Taken together, this updated meta-analysis extends and confirms the findings of our previous study, suggesting that in-hospital statin use leads to significant reduction of all-cause mortality in COVID-19 cases. Considering these results, statin therapy during hospitalization, while indicated, should be recommended.

Statin Use during Hospitalization and Short-Term Mortality in Acute Ischaemic Stroke with Chronic Kidney Disease

2018 ◽  
Vol 79 (5-6) ◽  
pp. 296-302 ◽  
Author(s):  
Xinmiao Zhang ◽  
Jing Jing ◽  
Xingquan Zhao ◽  
Liping Liu ◽  
Chunxue Wang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Ischaemic Stroke ◽  
Normal Renal Function ◽  
Stroke Patients ◽  
Short Term ◽  
All Cause Mortality ◽  
Short Term Mortality ◽  
Statin Use

Objectives: Statin use during hospitalization improves prognosis in patients with ischaemic stroke. However, it remains uncertain whether acute ischaemic stroke patients with chronic kidney disease (CKD) benefit from statin therapy. We investigated the effect of statin use during hospitalization in reducing short-term mortality of patients with ischaemic stroke and CKD. Methods: Data of first-ever ischaemic stroke patients without a history of pre-stroke statin treatment was derived from the China National Stroke Registry. Patients were stratified according to estimated glomerular filtration rate (eGFR): normal renal function (eGFR ≥90 mL/min/1.73 m2), mild CKD (eGFR 60–90 mL/min/1.73 m2) and moderate CKD (eGFR < 60 mL/min/1.73 m2). Multivariate logistic regression analysis was used to evaluate the association between statin use during hospitalization and all-cause mortality with different renal functions at 3-month follow-up. Results: Among 5,951 patients included, 2,595 (43.6%) patients were on statin use during hospitalization after stroke (45.7% in patients with normal renal function, 42.0% in patients with mild CKD, and 39.0% in patients with moderate CKD). Compared with the non-statin group, statin use during hospitalization was associated with decreased all-cause mortality in patients with normal renal function (OR 0.65, 95% CI 0.43–0.97, p = 0.04), mild CKD (OR 0.59, 95% CI 0.38–0.91, p = 0.02) and moderate CKD (OR 0.41, 95% CI 0.23–0.75, p = 0.004) at 3-month follow-up. Conclusions: Statin use during hospitalization was associated with decreased 3-month mortality of ischaemic stroke patients with mild and moderate CKD. However, the conclusion should be confirmed in further studies with larger population, especially with moderate CKD.

scholarly journals ABNORMALITAS INTERPRETASI ELEKTROKARDIOGRAM MENURUT GAMBARAN NEUROIMAGING PADA STROKE HEMORAGIK

2019 ◽  
Vol 37 (2) ◽  
Author(s):  
Dedi Sutia ◽  
Syarif Indra ◽  
Hendra Permana ◽  
Andi Fadilah Yusran Putri ◽  
Ribka Ankashima Sembiring
Keyword(s):  
Risk Factor ◽  
Left Ventricle ◽  
Hemorrhagic Stroke ◽  
Stroke Patients ◽  
Left Ventricle Hypertrophy ◽  
The Social ◽  
Ventricle Hypertrophy ◽  
Electrocardiogram Interpretation ◽  
Acute Hemorrhagic Stroke ◽  
Ecg Interpretation

ELECTROCARDIOGRAM INTERPRETATION ABNORMALITIES ACCORDING TO NEUROIMAGING IN HEMORRHAGIC STROKEABSTRACTIntoduction: Stroke is the third leading cause of death in the world (about 30% of cases of stroke are hemorrhagic). Cardiovascular disease has correlation to stroke, as risk factor and complication leading to mortality.Aim: To describe electrocardiogram (ECG) interpretation abnormalities in acute hemorrhagic stroke patients.Methods: This retrospective descriptive study evaluated the archive data of acute hemorrhagic stroke patients neurology ward General Hospital of Dr. M. Djamil Padang who according to inclusion and exclusion criteria since 1st February to 30th September 2018. The samples were an electrocardiography of acute hemorrhagic stroke patients. Data were analyzed by univariate analysis using statistical package for the social science (SPSS) software 23.Results: This study administered 81 subjects; 34 subjects (41.98%) were male and 47 subjects (58.02%) were female. The highest age group was 61-70 years old (29.63%). Most common risk factor was hypertension (66.68%). There were 40 intracerebral hemorrhage (ICH) subjects (49.38%) and 7 subarachnoid hemorrhage (SAH) subjects (11.11%) who had ECG interpretation abnormality. Both groups had left ventricle hypertrophy (LVH) as the most common ECG interpretation abnormality (ICH: 40.76%, SAH: 3.73%). The only one of ICH with secondary SAH subject had ECG interpretation abnormality.Discussion: Abnormal electrocardiogram interpretation were more common than normal electrocardiogram interpretation in acute hemorrhagic stroke subjects. Left ventricle hypertrophy (LVH) is the most common ECG interpretation abnormality in acute hemorrhagic stroke subjects.Keywords: ECG abnormalities, hemorrhagic stroke, intracerebral hemorrhage, subarachnoid hemorrhageABSTRAKPendahuluan: Stroke adalah penyebab kematian ketiga terbanyak di dunia (sekitar 30% kasus stroke adalah tipe stroke hemoragik). Masalah kardiovaskular berhubungan erat dengan stroke, sebagai faktor risiko dan komplikasi yang mengakibatkan mortalitas.Tujuan: Penelitian ini mendeskripsikan temuan abnormalitas interpretasi elektrokardiogram (EKG) menurut gambaran neuroimaging pada pasien stroke hemoragik akut.Metode: Penelitian deskriptif retrospektif ini mengevaluasi arsip data pasien stroke hemoragik akut di ruangan rawat inap neurologi ruangan rawat inap neurologi Rumah Sakit Umum Pusat Dr. M. Djamil, Padang yang sesuai dengan kriteria inklusi dan eksklusi sejak 1 Februari hingga 30 September 2018. Sampel penelitian adalah gambaran EKG pasien stroke hemoragik akut. Data dianalisis dengan analisis univariat menggunakan software statistical package for the social science (SPSS) 23.Hasil: Pada penelitian ini didapatkan 81 subjek; 34 subjek (41,98%) adalah laki-laki dan 47 subjek (58,02%) adalah perempuan. Kelompok usia subjek terbanyak adalah kelompok usia 61-70 tahun (29,63%). Faktor risiko terbanyak adalah hipertensi (66,68%). Ada 40 subjek perdarahan intraserebral (PIS) (49,38%) dan 7 subjek perdarahan subaraknoid (PSA) (11,11%) yang memiliki abnormalitas interpretasi EKG. Kedua kelompok subjek memiliki left ventricle hypertrophy (LVH) sebagai abnormalitas interpretasi EKG terbanyak (PIS:40,76%, PSA: 3,73%) Ada 1 subjek PIS dengan PSA sekunder (1,23%) dan subjek tersebut memiliki abnormalitas interpretasi EKG. Ada 14 subjek yang memiliki LVH sebagai abnormalitas interpretasi EKG dari 30,90% yang memiliki perdarahan stroke di kapsula interna (lokasi perdarahan terbanyak). Jumlah subjek dengan interpretasi EKG normal terbanyak adalah subjek dengan perdarahan di talamus.Diskusi: Left ventricle hypertrophy (LVH) adalah temuan abnormalitas interpretasi EKG terbanyak yang ditemukan pada subjek perdarahan stroke di kapsula interna (lokasi perdarahan terbanyak).  Jumlah subjek dengan interpretasi EKG normal terbanyak adalah subjek dengan perdarahan di talamus.Kata kunci: Abnormalitas EKG, perdarahan intraserebral, perdarahan subarakhnoid, stroke hemoragik

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