Association between statin use and mortality risks during the acute phase of ischemic stroke in patients admitted to an intensive care unit.

Natalia Eduarda Furlan,Juli Thomaz De Souza,Gustavo José Luvizutto,Luis Cuadrado Martin,Rodrigo Bazan,Silméia Garcia Zanati Bazan,Roberto Jorge Da Silva Franco,Gabriel Pinheiro Modolo,Ana Lúcia Gut,Fernanda Cristina Winckler

doi:10.1590/0004-282x20190172

Natalia Eduarda Furlan, Juli Thomaz De Souza + Show 8 more

Open Access

https://doi.org/10.1590/0004-282x20190172

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Abstract

To evaluate the association between statin use and mortality risk during the acute phase of ischemic stroke in patients admitted to an intensive care unit. This was an observational and prospective study of ischemic stroke patients aged ≥18, admitted to an intensive care unit. Medications used during the first 7 days after the ictus, as well as medications used previously, were recorded. The primary outcome was all-cause mortality during the first 7 days. We screened 212 patients and included 97 patients with ischemic stroke in the study period. The mortality rate among patients who used statins during the acute IS phase [14% (9/63)] was significantly lower than that among patients who did not use statins [41% (14/34); p=0.007]. This was confirmed in logistical regression with an 0.19 Odds Ratio - OR [p=0.018; 95% confidence interval - 95%CI 0.05-0.75]. Patients who died were older, had a higher incidence of acute myocardial infarction, higher scores on the NIHSS and lower systolic blood pressure. Statins and angiotensin converting enzyme inhibitors were used more frequently among survivors. These associations persisted even after adjustment for confounding variables. Statins and angiotensin converting enzyme inhibitors use during hospitalization were independently associated to a lower rate of all-cause mortality in the first 7 days of intensive care unit admission.

Highlights

Ischemic stroke is a common cause of death
In the current observational study, we found that statin use was associated with a lower mortality rate in the first week after ischemic stroke (IS)
Some authors believed that statin use in the acute phase of IS could be hazardous, because some preliminary data indicated that statin use was associated with hemorrhagic transformation

Summary

Introduction

Ischemic stroke is a common cause of death. The role of statins in the secondary prevention of the chronic ischemic stroke phase has been established. Objective: To evaluate the association between statin use and mortality risk during the acute phase of ischemic stroke in patients admitted to an intensive care unit. Conclusion: Statins and angiotensin converting enzyme inhibitors use during hospitalization were independently associated to a lower rate of all-cause mortality in the first 7 days of intensive care unit admission. Objetivo: Avaliar a associação entre o uso de estatinas e o risco de mortalidade durante a fase aguda do AVC isquêmico em pacientes internados em uma unidade de terapia intensiva. Conclusão: O uso de estatinas e inibidores da enzima conversora de angiotensina durante a hospitalização foram associados de forma independente à uma menor taxa de mortalidade por todas as causas nos primeiros 7 dias de internação na unidade de terapia intensiva. They found that, as opposed to expectations, the withdrawal of statins increased the probability of death in these patients

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