Abstract WP60: Can Early Statin Administration in the Acute Stage of Ischemic Stroke Intensify the Effect of Thrombolysis?

Abstract

Objective: We aimed to determine whether early statin use improves functional outcome and reduces post-thrombolytic symptomatic intracerebral hemorrhage (sICH) in acute symptomatic steno-occlusion of major cerebral arteries. Method: Using a prospective stroke registry, we identified a consecutive series of 337 patients who arrived within 6 h of stroke onset, had symptomatic stenosis (>50%) or occlusion, received thrombolysis, and were followed up at 3 months. We compared the 3-month modified Rankin Scale (mRS) score and sICH incidence during hospitalization according to post-thrombolytic statin use. Statin use was categorized into early use (≤1 day of onset; EU), late use (> 1 day of onset, LU), and no use (NU). sICH was defined as type-2 parenchymal hemorrhage with a more than 4 point decrease in NIHSS or death. Result: The patients’ mean age was 6e8.8 years (55.8% males; median baseline NIHSS, 13). Thrombolysis modalities were as follows: intravenous only (25.5%), intra-arterial only (31.2%), and combined (43.4%). EU was 34.1% (N = 115); LU, 15.4% (N = 52); and NU, 50.4% (N = 170). Percentages of favorable outcome (mRS, 0-1) differed significantly by statin use (39.1% in EU, 34.6% in LU, and 22.4% in NU; P = 0.007); sICH rates also differed (2.6%, 0.0%, and 10.0%, respectively; P = 0.005). Multivariable analyses showed an independent increase in the odds of favorable outcome and decrease in those of sICH after early stain use (Figure). Conclusion: Early statin use may improve functional outcome and reduce the occurrence of post-thrombolytic sICH.