Abstract WP516: Association of Pre-Stroke Statin Use With Initial Severity and In-Hospital Outcomes After First-Ever Acute Ischemic Stroke Among Patients With Atrial Fibrillation

Abstract

Background and Objective: Pretreatment with statins has been shown in several studies to be associated with reduced infarct volume and improved functional outcomes after ischemic stroke, but limited data were available specific to atrial fibrillation (AF) related ischemic stroke. The present study investigated the impact of statin use before onset on both initial severity and in-hospital outcomes in ischemic stroke patients with AF. Method: All cases of first-ever ischemic stroke patients with AF were prospectively identified from China Stroke Center Alliances from June 2015 to November 2017. Moderate and severe stroke was defined as National Institutes of Health Stroke Scale score ≥16. In-hospital adverse outcomes included intracerebral hemorrhage, deep vein thrombosis or pulmonary embolism, and pneumonia. We used logistic regression model to estimate propensity score and then we performed inverse probability weighting to assess the association of pre-stroke statin use with moderate and severe stroke and in-hospital adverse outcomes. Results: Among the 18,076 patients included, 1589 (3.9 %) had previously been treated with statins. The risk of moderate and severe stroke was significantly lower in pre-stroke statin users than nonusers (15.3% vs. 18.7%; adjusted odd ratio: 0.85; 95% confidence interval: 0.81-0.90; p<0.0001). Pre-stroke statin use was independently associated with reduced risk of in-hospital adverse outcomes (28.6% vs. 29.7%; adjusted odd ratio: 0.82; 95% confidence interval: 0.78-0.86; p<0.0001). Conclusion: Use of statins before first-ever ischemic stroke in patients with AF was associated with reduced stroke severity at admission and decreased risk of adverse outcomes during hospitalization.