Abstract WP166: The Effectiveness of Statin Therapy After Onset of Acute Ischemic Stroke With Large Vessel Occlusion

Abstract

Background: Statin therapy was reported to be associated with lower risk of recurrence of stroke and better functional outcomes in patients with acute ischemic stroke. However, the effect of statin therapy in patients with acute large vessel occlusion (LVO) was not well scrutinized. Thus, we evaluated the effect of statin administration after the onset of stroke on functional outcome based on the large registry study of acute LVO. Methods: RESCUE-Japan Registry-2 was a physician initiated registry study enrolled consecutive patients with acute LVO who were admitted within 24 hours of onset. We compared those with and without statin after onset in terms of modified Rankin Scale (mRS) at 90 days. We estimated the common odds ratio (OR) for a shift towards better mRS adjusting for confounders. Result: Among 2420patients registered, 2399 patients were eligible. Mean age was 75.9 years and men accounted for 55%. Statin were administered in 447 patients(19%) after admission. There are more atherothrombotic cerebral infarction (statin group: 34.2% vs non-statin group: 12.1%, p <0.0001), younger age (73.4 vs 76.5, p <0.0001), and lower NIHSS on admission (14 vs 17, p <0.0001) in the statin group. The adjusted common OR of the statin group was 1.22 (95% confidence interval [CI], 1.04 - 1.37; p =0.02) compared with the non-statin group. The safety profile was similar between groups. The mortality at 90 days was 4.7 % in the statin group lower than 12.5 % in the non-statin group (p <0.0001). The adjusted OR of statin group for mortality was 0.36 (95%CI 0.21 to 0.62, p = 0.022). Conclusions: Statin administration after onset of acute LVO was significantly associated with better functional outcome and mortality within 90 days. Our findings should be attested by randomized clinical trials in patients with acute LVO in future