The association of diabetes with ischemic stroke and transient ischemic attacks in a tertiary center in Saudi Arabia

ABSTRACT BACKGROUND: Diabetes mellitus increases stroke risk 1.5 to 3 fold, particularly ischemic stroke. There is limited literature on the impact of diabetes on stroke patients in Saudi Arabia. OBJECTIVES: Determine the association of diabetes on the presentation, subtypes, in-hospital complications and outcomes of ischemic stroke and transient ischemic attacks (TIA). DESIGN: IRB approved, retrospective chart review. SETTING: Tertiary care center. PATIENTS AND METHODS: All adult patients with ischemic stroke or TIA aged 18 years or older admitted from January 2016 to December 2017 were included. MAIN OUTCOME MEASURES: Stroke severity at presentation, stroke-related complications, discharge disposition and discharge modified Rankin Scale (mRS) in relation to diabetes. SAMPLE SIZE: 802 patients. RESULTS: Among 802 cases, 584 (72.8%) had diabetes; the majority (63.1%) were males. The mean age was younger in the non-diabetic stroke group (54.6 [15.5] years vs. 63.3 [9.9], P <.001). Hypertension (83.6% vs 49.1%, P <.001), dyslipidemia (38.9% vs. 28.9%, P =.009), prior stroke (27.7% vs. 19.3% P =.014), and ischemic heart disease (20.4% vs. 7.8%, P <.001) were more common in diabetic patients whereas smoking was more common (19.3% vs. 11.1%, P =.003) in the non-diabetic patients. The commonest subtype of stroke was large artery disease followed by small vessel disease. Both were more common in diabetic vs. non-diabetic patients (55.8% vs. 44%, P =.003), and (16.6% vs. 11%, P =.05) respectively. Diabetic stroke patients were more likely to have lacunar stroke (16.4% versus 9.2%, P =.009). TIAs occurred more commonly in the non-diabetic group (26.1% vs. 13.7%, P <.001). Non-diabetic patients had a better outcome (mRS score of 0–2) at discharge (62.4% vs. 45.9%, P =.002). CONCLUSIONS: Almost three-fourth stroke patients were diabetic in our cohort. Diabetic stroke patients were older, had multiple vascular comorbid conditions, presented late to the hospital, and were likely to have more disability at the time of discharge. Large vessel atherosclerosis as well as lacunar infarctions were more common in diabetic stroke patients. LIMITATIONS: Missing data about time of presentation in few patients, missing modified Rankin Scale score at discharge. CONFLICT OF INTEREST: None.

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Primary acute stroke thrombectomy within 3 h for large artery occlusion (PAST3-LAO): a pilot study

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2015-012172 ◽

2016 ◽

Vol 9 (4) ◽

pp. 352-356 ◽

Cited By ~ 1

Author(s):

Yahia Lodi ◽

Varun Reddy ◽

Gorge Petro ◽

Ashok Devasenapathy ◽

Anas Hourani ◽

...

Keyword(s):

Ischemic Stroke ◽

Intravenous Thrombolysis ◽

Recombinant Tissue Plasminogen Activator ◽

Artery Occlusion ◽

Large Artery ◽

Modified Rankin Scale ◽

Stroke Patients ◽

Nihss Score ◽

Tissue Plasminogen ◽

Poor Outcomes

Background and purposeIn recent trials, acute ischemic stroke (AIS) from large artery occlusion (LAO) was resistant to intravenous thrombolysis and adjunctive stent retriever thrombectomy (SRT) was associated with better perfusion and outcomes. Despite benefit, 39–68% of patients had poor outcomes. Thrombectomy in AIS with LAO within 3 h is performed secondary to intravenous thrombolysis, which may be associated with delay. The purpose of our study is to evaluate the safety, feasibility, recanalization rate, and outcome of primary SRT within 3 h without intravenous thrombolysis in AIS from LAO.MethodsBased on an institutionally approved protocol, stroke patients with LAO within 3 h were offered primary SRT as an alternative to intravenous recombinant tissue plasminogen activator. Consecutive patients who underwent primary SRT for LAO within 3 h from 2012 to 2014 were enrolled. Outcomes were measured using the modified Rankin Scale (mRS).Results18 patients with LAO of mean age 62.83±15.32 years and median NIH Stroke Scale (NIHSS) score 16 (10–23) chose primary SRT after giving informed consent. Near complete (TICI 2b in 1 patient) or complete (TICI 3 in 17 patients) recanalization was observed in all patients. Time to recanalization from symptom onset and groin puncture was 188.5±82.7 and 64.61±40.14 min, respectively. NIHSS scores immediately after thrombectomy, at 24 h and 30 days were 4 (0–12), 1 (0–12), and 0 (0–4), respectively. Asymptomatic perfusion-related hemorrhage developed in four patients (22%). 90-day outcomes were mRS 0 in 50%, mRS 1 in 44.4%, and mRS 2 in 5.6%.ConclusionsOur study demonstrates that primary SRT in AIS from LAO is safe and feasible and is associated with complete recanalization and good outcome. Further study is required.

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Edaravone Therapy Could be a Substitute for Decompressive Craniotomy/Craniectomy for Large Ischemic Stroke in Remote Areas with no Neurosurgeons

Advances in Bioscience and Clinical Medicine ◽

10.7575/aiac.abcmed.v.9n.1p.1 ◽

2021 ◽

Vol 9 (1) ◽

pp. 1

Author(s):

Seidu A. Richard

Keyword(s):

Ischemic Stroke ◽

National Institutes Of Health ◽

High Morbidity ◽

Large Artery ◽

Stroke Patients ◽

Success Story ◽

Severe Stroke ◽

Remote Areas ◽

Decompressive Craniotomy ◽

The Impact

The incidence of stroke has been a major task for medics and relatives globally. Stroke is the second most frequent disease with high morbidity as well as mortality worldwide. This is a very short and focus review on edaravone therapy. Due to the success story of edaravone in the management of stroke, it could be beneficial for severe stroke patients. The impact of edaravone was highest in the most severely afflicted stroke patients with National Institutes of Health Stroke Scale (NIHSS) scores ≥15 during admission. Large-artery atherosclerosis or cardioembolism stroke subtypes had the highest NIHSS scores. On the other hand, decompressive craniectomy is the resection of part of the skull so that edematous brain tissue can herniate outside. It is thus advocated that, edaravone therapy could be a substitute for decompressive craniotomy for large ischemic stroke in remote facilities with no neurosurgeons.

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The impact of post-stroke complications on in-hospital mortality depends on stroke severity

European Stroke Journal ◽

10.1177/2396987316681872 ◽

2016 ◽

Vol 2 (1) ◽

pp. 54-63 ◽

Cited By ~ 7

Author(s):

Alejandro Bustamante ◽

Dolors Giralt ◽

Teresa García-Berrocoso ◽

Marta Rubiera ◽

José Álvarez-Sabín ◽

...

Keyword(s):

Ischemic Stroke ◽

Random Forest ◽

Hospital Mortality ◽

Brain Edema ◽

Respiratory Infections ◽

National Institutes Of Health ◽

Stroke Severity ◽

Stroke Patients ◽

Post Stroke ◽

The Impact

Introduction Controversies remain on whether post-stroke complications represent an independent predictor of poor outcome or just a reflection of stroke severity. We aimed to identify which post-stroke complications have the highest impact on in-hospital mortality by using machine learning techniques. Secondary aim was identification of patient’s subgroups in which complications have the highest impact. Patients and methods Registro Nacional de Ictus de la Sociedad Española de Neurología is a stroke registry from 42 centers from the Spanish Neurological Society. Data from ischemic stroke patients were used to build a random forest by combining 500 classification and regression trees, to weight up the impact of baseline characteristics and post-stroke complications on in-hospital mortality. With the selected variables, a logistic regression analysis was performed to test for interactions. Results 12,227 ischemic stroke patients were included. In-hospital mortality was 5.9% and median hospital stay was 7(4–10) days. Stroke severity [National Institutes of Health Stroke Scale > 10, OR = 5.54(4.55–6.99)], brain edema [OR = 18.93(14.65–24.46)], respiratory infections [OR = 3.67(3.02–4.45)] and age [OR = 2.50(2.07–3.03) for >77 years] had the highest impact on in-hospital mortality in random forest, being independently associated with in-hospital mortality. Complications have higher odds ratios in patients with baseline National Institutes of Health Stroke Scale <10. Discussion Our study identified brain edema and respiratory infections as independent predictors of in-hospital mortality, rather than just markers of more severe strokes. Moreover, its impact was higher in less severe strokes, despite lower frequency. Conclusion Brain edema and respiratory infections were the complications with a greater impact on in-hospital mortality, with the highest impact in patients with mild strokes. Further efforts on the prediction of these complications could improve stroke outcome.

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Omentin-1: a biomarker in large artery ischaemic stroke patients

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00324-1 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Elham Nasif ◽

Osama A. Ragab ◽

Mahmoud E. Elhassanien ◽

Ayman M. Al-Malt

Keyword(s):

Ischaemic Stroke ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Prior History ◽

Diabetic Patients ◽

Stroke Severity ◽

Large Artery ◽

Stroke Patients ◽

Carotid Imt ◽

Infarction Volume

Abstract Background Omentin-1 is a novel adipocytokine that is related to atherosclerosis-based ischaemic cardiovascular disease and stroke. Previous studies have linked its lower levels with poor stroke outcomes. We aimed to assess the level of serum omentin-1 as a prognostic marker in patients with large artery ischaemic stroke. Methods Fifty ischaemic stroke patients suffering large artery ischaemic stroke and another 50 subjects without a prior history of strokes were recruited. All participants were subjected to neurological examinations, echocardiography and laboratory investigations including a lipid profile and HBA1c. Carotid intima-media thickness (IMT) was measured for all participants. Stroke patients were evaluated by the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Infarction volume was measured by magnetic resonance image (MRI) and serum level of omentin-1 was gauged for all participants. Results Carotid IMT significantly increased in stroke patients compared to control subjects. While serum omentin-1 levels were higher in control non-diabetic subjects, they were lower in diabetic patients with ischaemic stroke. Serum omentin-1 levels were inversely correlated with NIHSS, carotid IMT, infarction volume and mRS scores in all stroke patients. Serum omentin-1 level less than 24.5 ng/ml showed 93.7%sensitivity and 44.4% specificity in prediction of poor stroke outcome while values less than 27.8 ng/ml in non-diabetic stroke patients had sensitivity and specificity with 87.5% and 55.6% respectively. Conclusion Lower levels of serum omentin-1 are associated with increased ischaemic stroke severity and poor functional outcome.

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Abstract 009: The Impact of Participation in a Telestroke Network on In-hospital Mortality in Georgia

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.009 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Donglan Zhang ◽

Moges S Ido ◽

Lu Shi ◽

Dale Green

Keyword(s):

Ischemic Stroke ◽

Treatment Group ◽

Hospital Mortality ◽

Positive Association ◽

Teaching Hospitals ◽

P Value ◽

Stroke Severity ◽

Stroke Patients ◽

Stroke Registry ◽

The Impact

Objectives: Telestroke is the application of telemedicine to stroke care. We estimated the effect of participation in a telestroke network on in-hospital mortality in the state of Georgia, and explored its impact on mitigating the difference in mortality for patients admitted in nighttime compared to those admitted in daytime. Methods: We selected patients with ischemic stroke from 15 non-teaching hospitals in the Georgia’s Paul Coverdell Acute Stroke Registry from 2005 to 2016. We applied a quasi-experimental study design by classifying patients from 4 hospitals that participated in a telestroke network in 2009 as the treatment group, and patients from 11 hospitals that were not covered by the telestroke network as the comparison group. All selected hospitals are located in non-Metropolitan Areas. We compared mortality between treatment and comparison groups in 2005 - 2008 (pre-participation period for treatment group) and in 2009 - 2016 (post-participation period for treatment group), and estimated difference in in-hospital mortality attributable to participation in a telestroke network by applying a difference-in-differences approach, while adjusting for patients’ age, sex, race/ethnicity, insurance coverage, arrival mode, ambulatory status prior to the current stroke, stroke severity, medical history of atrial fibrillation/flutter and hospital admission time. Results: The mortality among ischemic stroke patients decreased in all selected hospitals over the last decade. Participation in a telestroke network significantly decreased in-hospital mortality by 3.2% (p-value= 0.003). There was a positive association between nighttime admission and in-hospital mortality in the entire patient sample. After controlling for the effect of participation in a telestroke network, the nighttime effect on mortality still remained significant (odds ratio=1.25, 95% confidence interval: 1.10 - 1.42). Conclusions: Acute ischemic stroke patients admitted in hospitals participating in a telestroke program had a more pronounced reduction in in-hospital mortality. However, telestroke coverage did not alter the effect of nighttime admission on in-hospital mortality.

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Women and Stroke: Different, yet Similar

Cerebrovascular Diseases Extra ◽

10.1159/000519540 ◽

2021 ◽

pp. 106-111

Author(s):

Nandini Mitta ◽

Sapna Erat Sreedharan ◽

Sankara P. Sarma ◽

Padmavathy N. Sylaja

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Functional Outcome ◽

South India ◽

Stroke Severity ◽

Sree Chitra Tirunal Institute ◽

Large Artery ◽

Stroke Subtype ◽

Excellent Outcome ◽

The Impact

Background: The impact of gender on acute ischemic stroke, in terms of presentation, severity, etiology, and outcome, is increasingly getting recognized. Here, we analyzed the gender-related differences in etiology and outcome of ischemic stroke in South India. Methods: Patients with first ever ischemic stroke within 1 week of onset presenting to the Comprehensive Stroke Care Centre, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India, were included in our study. Clinical and risk factor profile was documented. The stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) at onset, and stroke subtype classification was done using Trial of Org 10172 in Acute Ischemic Stroke criteria. The 3-month functional outcome was assessed using the modified Rankin Scale (mRS) with excellent outcome defined as an mRS ≤2. Results: Of the 742 patients, 250 (33.7%) were females. The age, clinical profile, and rate of reperfusion therapies did not differ between the genders. Women suffered more severe strokes (mean NIHSS 9.5 vs. 8.4, p = 0.03). While large artery atherosclerosis was more common in men (21.3% vs. 14.8%, p = 0.03), cardioembolic strokes secondary to rheumatic heart disease were more common in women (27.2% vs. 19.7%, p = 0.02). Men had a better 3-month functional outcome compared to women (68.6% vs. 61.2%, p = 0.04), but was not statistically significant after adjusting for confounders. Conclusion: Our data, from a single comprehensive stroke unit from South India, suggest that stroke in women are different, yet similar in many ways to men. Guideline-based treatment can result in comparable short-term outcomes, irrespective of admission stroke severity.

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Abstract TP332: Neuro-QOL Measures Have Improved Statistical Power versus the Dichotomized Modified Rankin Scale in Stroke Thrombolysis

Stroke ◽

10.1161/str.47.suppl_1.tp332 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Rajbeer S Sangha ◽

Richard Bernstein ◽

David Cella ◽

Carlos Corado ◽

Yvonne Curran ◽

...

Keyword(s):

Clinical Trials ◽

Ischemic Stroke ◽

Statistical Power ◽

Statistical Significance ◽

Stroke Severity ◽

Modified Rankin Scale ◽

Stroke Patients ◽

Nihss Score ◽

Number Of Patients ◽

Patient Reported

Introduction: The modified Rankin scale (mRS) is a reliable objective measure of disability and is widely applied in clinical trials. Health-related quality of life (QOL) measurements using Neuro-QOL provide validated measures of patient-reported outcomes. In a matched case-control study, we hypothesized that differences in QOL in favor of tPA would be readily detectable compared to the dichotomous mRS outcome traditionally applied in acute stroke research. Methods: From a single-center prospective cohort study, we identified ischemic stroke patients who received intravenous tPA, admitted between August 1, 2012 and July 31, 2014, and who had 3-month QOL and mRS outcomes. Using a propensity score matching algorithm based on age and stroke severity, ischemic stroke patients who did not receive tPA were selected as controls. The mRS was assessed by structured telephone interviews and Neuro-QOL using short forms analyzing domains of upper extremity (UE), lower extremity (LE), executive function (EF), and general cognition (GC). T-scores for Neuro-QOL domains are referenced to the general population (mean 50, SD 10). We assessed differences in mRS (dichotomized 0-1 vs. 2-5) and QOL T-scores (continuous) in each domain using appropriate tests. Results: A total of 90 patients were analyzed (45 tPA and 45 controls; median NIHSS score 7). There was no statistical difference between the two groups by age (p=0.967) and NIHSS score (p=0.855). When comparing Neuro-QOL T-scores, higher scores were reported for domains of EF (tPA: 52 vs. controls: 46; p=0.032) and LE function (tPA: 46 vs. controls: 41; p=0.008) among tPA patients compared to controls. No differences were noted for UE or GC QOL T-scores. Using the mRS, the results were not statistically significant (dichotomous: 0-1, tPA: 75.6% vs. controls: 57.8%, p=0.117). Conclusion: Neuro-QOL offers a complementary tool for assessment of neurological function and may help identify finer grades of functional change and outcomes for stroke patients undergoing a specific therapy. The mRS requires a greater number of patients to show statistical significance while utilization of a continuous measurement of function from the patient perspective may improve statistical power in future clinical trials.

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Abstract TP207: Pre-stroke Dementia is Associated With Poor Functional Outcome After Acute Ischemic Stroke: The Fukuoka Stroke Registry

Stroke ◽

10.1161/str.47.suppl_1.tp207 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Yoshinobu Wakisaka ◽

Ryu Matsuo ◽

Junya Hata ◽

Junya Kuroda ◽

Tetsuro Ago ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Functional Outcome ◽

Stroke Severity ◽

Large Artery ◽

Stroke Patients ◽

Poor Functional Outcome ◽

Vessel Occlusion ◽

Stroke Registry ◽

Increased Risk

Introduction: With an aging population, an increased number of acute stroke patients with pre-stroke dementia is expected. Although both stroke and dementia are major cause of disability, the effect of pre-stroke dementia on functional outcome after stroke has been still on debate. Hypothesis: Pre-stroke dementia is associated with poor functional outcome after acute ischemic stroke. Methods: Of 9198 stroke patients registered in the Fukuoka Stroke Registry in Japan from June 2007 to May 2014, 3843 patients with first-ever ischemic stroke within 24h of onset, who had been functionally independent before the onset, were enrolled in this study (cardioembolism [n=926], large artery atherosclerosis [n=583], small vessel occlusion [n=1045], others [n=1289]). Pre-stroke dementia was defined as any type of dementia that was present prior to the stroke. For propensity score (PS)-matched analysis, 320 pairs of patients with and without pre-stroke dementia were also selected. Study outcome was poor functional outcome (modified Rankin Scale 3-6) at discharge. Results: In the total cohort, 330 (8.6%) had pre-stroke dementia. The age (80±8 vs 69±13, year, mean±SD, p<0.01), frequencies of female (46 vs 36, %, p<0.01) and cardioembolism (41 vs 23, %, p<0.01), and NIHSS score on admission (6 [3 - 12] vs 3 [1 - 6], median [interquartile], p<0.01) were higher in patients with pre-stroke dementia than those without the dementia. Poor functional outcome (62 vs 25, %, p<0.01) were more prevalent in patients with pre-stroke dementia than those without the dementia. Multivariable-adjusted analysis showed that pre-stroke dementia was significantly associated with increased risk for poor functional outcome (OR 2.3, 95% CI 1.7-3.2). There were no interactions between pre-stroke dementia and 4 variables (age, sex, stroke subtype, and initial stroke severity [NIHSS≤7 or NIHSS≥8]). In the PS-matched analysis, pre-stroke dementia was still associated with poor functional outcome (OR 4.3, 95%CI 2.1-8.8). Conclusions: Pre-stroke dementia was significantly associated with poor functional outcome at discharge in patients with acute ischemic stroke.

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Associated Factors and Long-Term Prognosis of 24-Hour Worsening of Arterial Patency After Ischemic Stroke

Stroke ◽

10.1161/strokeaha.119.025787 ◽

2019 ◽

Vol 50 (10) ◽

pp. 2752-2760 ◽

Cited By ~ 1

Author(s):

João Pedro Marto ◽

Dimitris Lambrou ◽

Ashraf Eskandari ◽

Stefania Nannoni ◽

Davide Strambo ◽

...

Keyword(s):

Ischemic Stroke ◽

Multivariable Analysis ◽

Vascular Imaging ◽

Stroke Severity ◽

Modified Rankin Scale ◽

Long Term Outcome ◽

Long Term Prognosis ◽

The Impact ◽

Arterial Patency

Background and Purpose— Early arterial recanalization in acute ischemic stroke is strongly associated with better outcomes. However, early worsening of arterial patency was seldom studied. We investigated potential predictors and long-term prognosis of worsening of arterial patency at 24 hours after stroke onset. Methods— Patients from the Acute Stroke Registry and Analysis of Lausanne registry including admission and 24-hour vascular imaging (computed tomography or magnetic resonance angiography) were included. Worsening of arterial patency was defined as a new occlusion and significant stenosis in any extracranial or intracranial artery, comparing 24 hours with admission imaging. Variables associated with worsening of arterial patency were assessed by stepwise multiple logistic regression. The impact of arterial worsening on 3-month outcome was investigated with an adjusted modified Rankin Scale shift analysis. Results— Among 2152 included patients, 1387 (64.5%) received intravenous thrombolysis and endovascular treatment, and 65 (3.0%) experienced 24-hour worsening of arterial patency. In multivariable analysis, history of hypertension seemed protective (adjusted odds ratio [aOR], 0.45; 95% CI, 0.27–0.75) while higher admission National Institutes of Health Stroke Scale (aOR, 1.06; 95% CI, 1.02–1.10), intracranial (aOR, 4.78; 95% CI, 2.03–11.25) and extracranial stenosis (aOR, 3.67; 95% CI, 1.95–6.93), and good collaterals (aOR, 3.71; 95% CI, 1.54–8.95) were independent predictors of worsening of arterial patency. Its occurrence was associated with a major unfavorable shift in the distribution of the modified Rankin Scale at 3 months (aOR, 5.97; 95% CI, 3.64–9.79). Conclusions— Stroke severity and admission vascular imaging findings may help to identify patients at a higher risk of developing worsening of arterial patency at 24 hours. The impact of worsening of arterial patency on long-term outcome warrants better methods to detect and prevent this early complication.

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Prestroke statin use enhances collateralization in acute ischemic stroke patients

Restorative Neurology and Neuroscience ◽

10.3233/rnn-201012 ◽

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.

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