Abstract
Background: We evaluated the impact of prior statin use on successful reperfusion and stroke outcomes after endovascular treatment (EVT). Method: Using consecutive multicenter databases, we enrolled acute ischemic stroke patients receiving EVT between 2015 and 2021. Patients were classified into prior statin users and no prior statin users after a review of premorbid medications. The primary outcome measure was successful reperfusion defined as modified TICI grade 2b or 3 after EVT. Secondary outcome measures were early neurologic deterioration (END) and a 3-month modified Rankin Scale (mRS) score of 0 to 2. Results: Among 385 patients receiving EVT, 74 (19.2%) were prior statin users, who had a significantly higher successful reperfusion rate compared with no prior statin users (94.6% versus 78.8%, p = 0.002). Successful reperfusion and END occurrence were improved according to statin intensity with a dose–response relationship. In multivariate analysis, prior statin was associated with successful reperfusion after EVT (adjusted odds ratio (95% confidence interval) 5.31 (1.67–16.86)). In addition, prior statin was associated with a lower occurrence of END and good functional status. Conclusion: Our study showed that prior statin use before ischemic stroke might improve successful reperfusion and stroke outcomes after EVT.
Highlights
Endovascular treatment (EVT) has an important role in improving stroke outcomes in patients with large vessel occlusion [1]
In the current real-world practice of statin use, which is continuously increasing [20,21], we aimed to investigate the effect of prior use of statins on reperfusion and outcomes in patients receiving EVT
We identified acute ischemic stroke patients treated with EVT
Summary
Endovascular treatment (EVT) has an important role in improving stroke outcomes in patients with large vessel occlusion [1]. Major clinical trials reported that 67% of patients undergoing EVT had poor outcomes despite successful reperfusion [2]. Reasons for this might be that reperfusion injury, re-occlusion, and no-reflow phenomenon are responsible for the poor outcomes [3]. Several studies investigated which indicators influenced a good or poor prognosis in patients who underwent EVT [4,5]. An HMG Co-A reductase inhibitor, is used widely for the primary and secondary prevention of stroke [6]. Statins have pleiotropic effects, including anti-inflammatory, anti-thrombotic, and antioxidative effects, as well as cholesterol-lowering effects [7,8,9]
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