Abstract
The objective of this study was to investigate the potential benefits of statin therapy initiation in acute stroke in patients with active cancer. This study was conducted in two parts. First, data from patients who are presented with stroke and active cancer were obtained from prospectively collected multicenter hospital-based stroke registries. Patients were classified into statin user and non-user groups; the statin group was further divided into low-potency and high-potency statin subgroups. The primary outcome was time to mortality. Second, we obtained data from the Korean National Health Information Service-National Sample Cohort (NHIS-NSC) database for external validation and analyzed the effect of statins on mortality, taking compliance into consideration. For the stroke registry cohort, statin use was independently associated with reduced mortality in a multivariable model [hazard ratio (HR) = 0.675, 95% confidence interval (CI) = 0.457–0.996]. There was no interaction between statin use and cancer characteristics, vascular risk factors, or laboratory findings. A dose-dependent relationship between statin use and survival was also demonstrated. Analysis of the NHIS-NSC database found a similar association between statin therapy and reduced mortality (adjusted HR = 0.64, 95% CI = 0.45–0.90) and this effect persisted even after controlling for the adherence of statin use (HR = 0.60, 95% CI = 0.41–0.89). Statin therapy could be associated with reduced mortality in patients with acute stroke and active cancer.
Highlights
Statins, or 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, reduce the primary and secondary risk of stroke and stroke mortality [1]
Besides its ability to alter lipid metabolism, retrospective studies have found that statin use improved the outcome of acute ischemic strokes, and this acute effect of statin is thought to be a result of its neuroprotective pleiotropic properties, such as vasodilatory, anti-thrombotic, and anti-inflammatory actions [3]
For the stroke registry cohort, out of a total of 9,441 patients who were registered during the study period, 316 patients with active cancer were selected for analysis (Figure 1A)
Summary
3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, reduce the primary and secondary risk of stroke and stroke mortality [1]. Besides its ability to alter lipid metabolism, retrospective studies have found that statin use improved the outcome of acute ischemic strokes, and this acute effect of statin is thought to be a result of its neuroprotective pleiotropic properties, such as vasodilatory, anti-thrombotic, and anti-inflammatory actions [3]. The pleiotropic effect of statins has been extensively studied in non-cardiovascular diseases. Both in vitro and in vivo studies have reported the anticancer property of statins [4]. A large meta-analysis from Women’s Health Initiatives demonstrated the beneficial effect of statins on cancer, finding that regular use of statin or other lipid-lowering medications was associated with decreased cancer death, regardless of the type, duration, or potency of statin medication used [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
