BACKGROUND AND PURPOSE: Multiple studies suggest that statin use before acute ischemic stroke is associated with improved functional outcome. However, available evidence is conflicting, and several published reports are limited by small sample sizes. We therefore investigated the effect of antecedent use of statins on stroke outcome by performing a meta-analysis of all results from published studies as well as our own unpublished data. METHODS: We performed a systematic literature search and meta-analysis of studies investigating the association between prestroke statin use and clinical outcome and included additional data from 126 prestroke statin users and 767 nonusers enrolled at our institution. A total of 12 studies, comprising 2013 statin users and 9682 nonusers, was meta-analyzed using a random effects model. We also meta-analyzed results for individual Trial of ORG 10172 in Acute Stroke Treatment stroke subtypes to determine whether the effect of statin use differed across subtypes using the Breslow-Day test. RESULTS: Meta-analysis of all available data identified an association between prestroke statin use and improved functional outcome (OR, 1.62; 95% CI, 1.39 to 1.88), but we uncovered evidence of publication bias. The effect of statin use on functional outcome was found to be larger for small vessel strokes compared with other subtypes (Breslow-Day P=0.008). CONCLUSIONS: Antecedent use of statins is associated with improved outcome in patients with acute ischemic stroke. This association appears to be stronger in patients with small vessel stroke subtype. However, evidence of publication bias in the existing literature suggests these findings should be interpreted with caution.
BACKGROUND AND PURPOSE: Multiple studies suggest that statin use before acute ischemic stroke is associated with improved functional outcome. However, available evidence is conflicting, and several published reports are limited by small sample sizes. We therefore investigated the effect of antecedent use of statins on stroke outcome by performing a meta-analysis of all results from published studies as well as our own unpublished data. METHODS: We performed a systematic literature search and meta-analysis of studies investigating the association between prestroke statin use and clinical outcome and included additional data from 126 prestroke statin users and 767 nonusers enrolled at our institution. A total of 12 studies, comprising 2013 statin users and 9682 nonusers, was meta-analyzed using a random effects model. We also meta-analyzed results for individual Trial of ORG 10172 in Acute Stroke Treatment stroke subtypes to determine whether the effect of statin use differed across subtypes using the Breslow-Day test. RESULTS: Meta-analysis of all available data identified an association between prestroke statin use and improved functional outcome (OR, 1.62; 95% CI, 1.39 to 1.88), but we uncovered evidence of publication bias. The effect of statin use on functional outcome was found to be larger for small vessel strokes compared with other subtypes (Breslow-Day P=0.008). CONCLUSIONS: Antecedent use of statins is associated with improved outcome in patients with acute ischemic stroke. This association appears to be stronger in patients with small vessel stroke subtype. However, evidence of publication bias in the existing literature suggests these findings should be interpreted with caution.
Authors: Sung Sug Yoon; James Dambrosia; Julio Chalela; Mustapha Ezzeddine; Steven Warach; Joseph Haymore; Lisa Davis; Alison E Baird Journal: BMC Med Date: 2004-03-23 Impact factor: 8.775
Authors: Mi Ji Lee; Oh Young Bang; Suk Jae Kim; Gyeong Moon Kim; Chin Sang Chung; Kwang Ho Lee; Bruce Ovbiagele; David S Liebeskind; Jeffrey L Saver Journal: Cerebrovasc Dis Date: 2014-01-16 Impact factor: 2.762
Authors: Manuel Cappellari; Paolo Bovi; Giuseppe Moretto; Andrea Zini; Patrizia Nencini; Maria Sessa; Mauro Furlan; Alessandro Pezzini; Giovanni Orlandi; Maurizio Paciaroni; Tiziana Tassinari; Gaetano Procaccianti; Vincenzo Di Lazzaro; Luigi Bettoni; Carlo Gandolfo; Giorgio Silvestrelli; Maurizia Rasura; Giuseppe Martini; Maurizio Melis; Maria Vittoria Calloni; Fabio Chiodo-Grandi; Simone Beretta; Maria Guarino; Maria Concetta Altavista; Simona Marcheselli; Giampiero Galletti; Laura Adobbati; Massimo Del Sette; Armando Mancini; Daniele Orrico; Serena Monaco; Anna Cavallini; Rossella Sciolla; Francesco Federico; Umberto Scoditti; Fabio Brusaferri; Claudio Grassa; Luigi Specchio; Maria Roberta Bongioanni; Marco Sparaco; Mauro Zampolini; Gabriele Greco; Rinaldo Colombo; Bruno Passarella; Alessandro Adami; Domenico Consoli; Danilo Toni Journal: Neurology Date: 2013-01-23 Impact factor: 9.910