Statin therapy does not affect the radiographic and clinical profile of patients with TIA and minor stroke

Negar Asdaghi, J. I. Coulter, J. Modi, M. C. Camden, A. Qazi, M. Goyal, Tatjana Rundek, S. B. Coutts

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: Acute statin therapy improves neurologic outcome and diminishes infarct growth in animal models of stroke. Clinical studies suggest that premorbid and early statin use is associated with improved outcome after major stroke. We studied the association between statin therapy and radiographic and clinical outcomes in patients with high-risk TIA and minor stroke. MATERIALS AND METHODS: Patients with high-risk TIA and minor stroke (NIHSS ≤3) were prospectively enrolled within 24 hours of symptom onset. Patients were followed clinically for 3 months, and a subset had a repeat MR imaging at 90 days. RESULTS: Of 418 patients, 23% were prescribed statins before their stroke. Statins were continued in 20% and initiated in 42%. Patients on prior statin therapy were older and more hypertensive, treated with aspirin, and more likely to have symptomatic carotid disease compared with those not on statin. Adjusting for these differences, prior statin treatment was not associated with DWI positivity (adjusted OR = 1.3; 95% CI, 0.77-2.1; P = .32) or smaller median baseline infarct volume, 1.1 mL (interquartile range = 4) versus 1 mL (interquartile range = 2.5; P = .56). Early or continued treatment with statins did not improve the risk of clinical deterioration (adjusted OR = 0.66; 95% CI, 0.27-1.6; P = .35) or poor functional outcome at 3 months (adjusted OR = 0.66; 95% CI, 0.35-1.24; P = .19). CONCLUSIONS: Prestroke or early-stroke statin therapy was not associated with a reduction in the number of DWI lesions, infarct volume, or improved clinical or functional outcome at 3 months. The effect of acute statin treatment in patients with ischemic stroke/TIA remains unclear and needs further investigation.

Original languageEnglish (US)
Pages (from-to)1076-1080
Number of pages5
JournalAmerican Journal of Neuroradiology
Volume36
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Stroke
Therapeutics
Nervous System
Aspirin
Animal Models

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

Cite this

Statin therapy does not affect the radiographic and clinical profile of patients with TIA and minor stroke. / Asdaghi, Negar; Coulter, J. I.; Modi, J.; Camden, M. C.; Qazi, A.; Goyal, M.; Rundek, Tatjana; Coutts, S. B.

In: American Journal of Neuroradiology, Vol. 36, No. 6, 01.06.2015, p. 1076-1080.

Research output: Contribution to journalArticle

Asdaghi, Negar ; Coulter, J. I. ; Modi, J. ; Camden, M. C. ; Qazi, A. ; Goyal, M. ; Rundek, Tatjana ; Coutts, S. B. / Statin therapy does not affect the radiographic and clinical profile of patients with TIA and minor stroke. In: American Journal of Neuroradiology. 2015 ; Vol. 36, No. 6. pp. 1076-1080.
@article{8f9d1e868db948e498aa082e7022be33,
title = "Statin therapy does not affect the radiographic and clinical profile of patients with TIA and minor stroke",
abstract = "BACKGROUND AND PURPOSE: Acute statin therapy improves neurologic outcome and diminishes infarct growth in animal models of stroke. Clinical studies suggest that premorbid and early statin use is associated with improved outcome after major stroke. We studied the association between statin therapy and radiographic and clinical outcomes in patients with high-risk TIA and minor stroke. MATERIALS AND METHODS: Patients with high-risk TIA and minor stroke (NIHSS ≤3) were prospectively enrolled within 24 hours of symptom onset. Patients were followed clinically for 3 months, and a subset had a repeat MR imaging at 90 days. RESULTS: Of 418 patients, 23{\%} were prescribed statins before their stroke. Statins were continued in 20{\%} and initiated in 42{\%}. Patients on prior statin therapy were older and more hypertensive, treated with aspirin, and more likely to have symptomatic carotid disease compared with those not on statin. Adjusting for these differences, prior statin treatment was not associated with DWI positivity (adjusted OR = 1.3; 95{\%} CI, 0.77-2.1; P = .32) or smaller median baseline infarct volume, 1.1 mL (interquartile range = 4) versus 1 mL (interquartile range = 2.5; P = .56). Early or continued treatment with statins did not improve the risk of clinical deterioration (adjusted OR = 0.66; 95{\%} CI, 0.27-1.6; P = .35) or poor functional outcome at 3 months (adjusted OR = 0.66; 95{\%} CI, 0.35-1.24; P = .19). CONCLUSIONS: Prestroke or early-stroke statin therapy was not associated with a reduction in the number of DWI lesions, infarct volume, or improved clinical or functional outcome at 3 months. The effect of acute statin treatment in patients with ischemic stroke/TIA remains unclear and needs further investigation.",
author = "Negar Asdaghi and Coulter, {J. I.} and J. Modi and Camden, {M. C.} and A. Qazi and M. Goyal and Tatjana Rundek and Coutts, {S. B.}",
year = "2015",
month = "6",
day = "1",
doi = "10.3174/ajnr.A4257",
language = "English (US)",
volume = "36",
pages = "1076--1080",
journal = "American Journal of Neuroradiology",
issn = "0195-6108",
publisher = "American Society of Neuroradiology",
number = "6",

}

TY - JOUR

T1 - Statin therapy does not affect the radiographic and clinical profile of patients with TIA and minor stroke

AU - Asdaghi, Negar

AU - Coulter, J. I.

AU - Modi, J.

AU - Camden, M. C.

AU - Qazi, A.

AU - Goyal, M.

AU - Rundek, Tatjana

AU - Coutts, S. B.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - BACKGROUND AND PURPOSE: Acute statin therapy improves neurologic outcome and diminishes infarct growth in animal models of stroke. Clinical studies suggest that premorbid and early statin use is associated with improved outcome after major stroke. We studied the association between statin therapy and radiographic and clinical outcomes in patients with high-risk TIA and minor stroke. MATERIALS AND METHODS: Patients with high-risk TIA and minor stroke (NIHSS ≤3) were prospectively enrolled within 24 hours of symptom onset. Patients were followed clinically for 3 months, and a subset had a repeat MR imaging at 90 days. RESULTS: Of 418 patients, 23% were prescribed statins before their stroke. Statins were continued in 20% and initiated in 42%. Patients on prior statin therapy were older and more hypertensive, treated with aspirin, and more likely to have symptomatic carotid disease compared with those not on statin. Adjusting for these differences, prior statin treatment was not associated with DWI positivity (adjusted OR = 1.3; 95% CI, 0.77-2.1; P = .32) or smaller median baseline infarct volume, 1.1 mL (interquartile range = 4) versus 1 mL (interquartile range = 2.5; P = .56). Early or continued treatment with statins did not improve the risk of clinical deterioration (adjusted OR = 0.66; 95% CI, 0.27-1.6; P = .35) or poor functional outcome at 3 months (adjusted OR = 0.66; 95% CI, 0.35-1.24; P = .19). CONCLUSIONS: Prestroke or early-stroke statin therapy was not associated with a reduction in the number of DWI lesions, infarct volume, or improved clinical or functional outcome at 3 months. The effect of acute statin treatment in patients with ischemic stroke/TIA remains unclear and needs further investigation.

AB - BACKGROUND AND PURPOSE: Acute statin therapy improves neurologic outcome and diminishes infarct growth in animal models of stroke. Clinical studies suggest that premorbid and early statin use is associated with improved outcome after major stroke. We studied the association between statin therapy and radiographic and clinical outcomes in patients with high-risk TIA and minor stroke. MATERIALS AND METHODS: Patients with high-risk TIA and minor stroke (NIHSS ≤3) were prospectively enrolled within 24 hours of symptom onset. Patients were followed clinically for 3 months, and a subset had a repeat MR imaging at 90 days. RESULTS: Of 418 patients, 23% were prescribed statins before their stroke. Statins were continued in 20% and initiated in 42%. Patients on prior statin therapy were older and more hypertensive, treated with aspirin, and more likely to have symptomatic carotid disease compared with those not on statin. Adjusting for these differences, prior statin treatment was not associated with DWI positivity (adjusted OR = 1.3; 95% CI, 0.77-2.1; P = .32) or smaller median baseline infarct volume, 1.1 mL (interquartile range = 4) versus 1 mL (interquartile range = 2.5; P = .56). Early or continued treatment with statins did not improve the risk of clinical deterioration (adjusted OR = 0.66; 95% CI, 0.27-1.6; P = .35) or poor functional outcome at 3 months (adjusted OR = 0.66; 95% CI, 0.35-1.24; P = .19). CONCLUSIONS: Prestroke or early-stroke statin therapy was not associated with a reduction in the number of DWI lesions, infarct volume, or improved clinical or functional outcome at 3 months. The effect of acute statin treatment in patients with ischemic stroke/TIA remains unclear and needs further investigation.

UR - http://www.scopus.com/inward/record.url?scp=84930977934&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930977934&partnerID=8YFLogxK

U2 - 10.3174/ajnr.A4257

DO - 10.3174/ajnr.A4257

M3 - Article

VL - 36

SP - 1076

EP - 1080

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 6

ER -