Literature DB >> 33555418

Combined therapy of intensive statin plus intravenous rt-PA in acute ischemic stroke: the INSPIRE randomized clinical trial.

Wan-Yong Yang1,2, Yu-Feng Li1,2, Zi-Ran Wang3, Tian-Xia Yu4, Dong-Juan Xu5, Nan Yang6, Xiao-Yuan Niu7, Xue-Li Cai8, Wen-Yan Zhuo9, Xue-Mei Wu10, Min Yan11, Jun-Shan Zhou12, Hao-Wen Zhang13, Zhi-Gang Liang14, Wen-Jun Wu15, Jian-Hua Cheng16, Li-An Huang1,2, Yu-Sheng Zhang1,2, Ying Guan17, Ze-Feng Tan1,2, Dan Lu1,2, Niu He1,2, Da-Wei Dong1,2, Hui-Li Zhu1,2, Bing Yang1,2, Qing-Yu Shen18, An-Ding Xu19,20.   

Abstract

OBJECTIVE: To investigate the safety and efficacy of intensive statin in the acute phase of ischemic stroke after intravenous thrombolysis therapy.
METHODS: A total of 310 stroke patients treated with rt-PA were randomly scheduled into the intensive statin group (rosuvastatin 20 mg daily × 14 days) and the control group (rosuvastatin 5 mg daily × 14 days). The primary clinical endpoint was excellent functional outcome (mRS ≤ 1) at 3 months, and the primary safety endpoint was symptomatic intracranial hemorrhage (sICH) in 90 days.
RESULTS: The intensive statin users did not achieve a favorable outcome in excellent functional outcome (mRS ≤ 1) at 3 months compared with controls (70.3% vs. 66.5%, p = 0.464). Intensive statin also not significantly improved the overall distribution of scores on the modified Rankin scale, as compared with controls (p = 0.82 by the Cochran-Mantel-Haenszel test). The incidence of primary safety endpoint events (sICH) in 90 days did not significantly differ between the intensive statin group and control group (0.6% vs. 1.3%, p > 0.999).
CONCLUSION: The INSPIRE study indicated that intensive statin therapy may not improve clinical outcomes compared with the low dose of statin therapy in AIS patients undergoing intravenous thrombolysis, and the two groups had similar safety profile. CLINICAL TRIAL REGISTRATION: URL: http://www.chictr.org . Unique identifier: ChiCTR-IPR-16008642.

Entities:  

Keywords:  Acute ischemic stroke; Good functional outcome; Intravenous thrombolysis; Statin; Symptomatic intracranial hemorrhage

Year:  2021        PMID: 33555418     DOI: 10.1007/s00415-020-10388-3

Source DB:  PubMed          Journal:  J Neurol        ISSN: 0340-5354            Impact factor:   4.849


  20 in total

1.  Prior statin use may be associated with improved stroke outcome after tissue plasminogen activator.

Authors:  José Alvarez-Sabín; Rafael Huertas; Manolo Quintana; Marta Rubiera; Pilar Delgado; Marc Ribó; Carlos A Molina; Joan Montaner
Journal:  Stroke       Date:  2007-02-01       Impact factor: 7.914

2.  High-dose atorvastatin after stroke or transient ischemic attack.

Authors:  Pierre Amarenco; Julien Bogousslavsky; Alfred Callahan; Larry B Goldstein; Michael Hennerici; Amy E Rudolph; Henrik Sillesen; Lisa Simunovic; Michael Szarek; K M A Welch; Justin A Zivin
Journal:  N Engl J Med       Date:  2006-08-10       Impact factor: 91.245

3.  2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke.

Authors:  Karen L Furie; Mahesh V Jayaraman
Journal:  Stroke       Date:  2018-01-24       Impact factor: 7.914

4.  Statin pretreatment may increase the risk of symptomatic intracranial haemorrhage in thrombolysis for ischemic stroke: results from a case-control study and a meta-analysis.

Authors:  Sergi Martinez-Ramirez; Raquel Delgado-Mederos; Rebeca Marín; Marc Suárez-Calvet; María Pilar Sáinz; Aída Alejaldre; Ángela Vidal-Jordana; Josep Lluís Martí-Vilalta; Joan Martí-Fàbregas
Journal:  J Neurol       Date:  2011-06-18       Impact factor: 4.849

5.  Intensive lipid lowering with atorvastatin in patients with stable coronary disease.

Authors:  John C LaRosa; Scott M Grundy; David D Waters; Charles Shear; Philip Barter; Jean-Charles Fruchart; Antonio M Gotto; Heiner Greten; John J P Kastelein; James Shepherd; Nanette K Wenger
Journal:  N Engl J Med       Date:  2005-03-08       Impact factor: 91.245

6.  Consensus statement on the use of intravenous recombinant tissue plasminogen activator to treat acute ischemic stroke by the Chinese Stroke Therapy Expert Panel.

Authors:  An-Ding Xu; Yong-Jun Wang; David Z Wang
Journal:  CNS Neurosci Ther       Date:  2013-05-27       Impact factor: 5.243

7.  Dose-related effects of statins on symptomatic intracerebral hemorrhage and outcome after thrombolysis for ischemic stroke.

Authors:  Jan F Scheitz; David J Seiffge; Serdar Tütüncü; Henrik Gensicke; Heinrich J Audebert; Leo H Bonati; Jochen B Fiebach; Christopher Tränka; Philippe A Lyrer; Matthias Endres; Stefan T Engelter; Christian H Nolte
Journal:  Stroke       Date:  2013-12-24       Impact factor: 7.914

8.  Risk factors for primary cerebral hemorrhage: a population-based study--the Stroke Registry of Dijon.

Authors:  M Giroud; E Creisson; H Fayolle; N André; F Becker; D Martin; R Dumas
Journal:  Neuroepidemiology       Date:  1995       Impact factor: 3.282

9.  Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.

Authors:  Edward C Jauch; Jeffrey L Saver; Harold P Adams; Askiel Bruno; J J Buddy Connors; Bart M Demaerschalk; Pooja Khatri; Paul W McMullan; Adnan I Qureshi; Kenneth Rosenfield; Phillip A Scott; Debbie R Summers; David Z Wang; Max Wintermark; Howard Yonas
Journal:  Stroke       Date:  2013-01-31       Impact factor: 7.914

10.  Lipid profile, statin use, and outcome after intravenous thrombolysis for acute ischaemic stroke.

Authors:  M Uyttenboogaart; M W Koch; K Koopman; P C Vroomen; G J Luijckx; J De Keyser
Journal:  J Neurol       Date:  2008-03-14       Impact factor: 4.849

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  2 in total

Review 1.  Effect of drug interventions on cerebral hemodynamics in ischemic stroke patients.

Authors:  Osian Llwyd; Jui-Lin Fan; Martin Müller
Journal:  J Cereb Blood Flow Metab       Date:  2021-11-05       Impact factor: 6.200

2.  Efficacy of Rosuvastatin Combined with rt-PA Intravenous Thrombolytic Therapy for Elderly Acute Ischemic Stroke Patients.

Authors:  Jianzhong Zhu; Shan Wang; Zhenqiu Chen; Qiqi Cheng
Journal:  Comput Math Methods Med       Date:  2022-06-15       Impact factor: 2.809

  2 in total

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