Inflammation, Statins, and Outcome After Ischemic Stroke

Abstract

To the Editor: In the recently article by Jonsson and Asplund,1 the authors demonstrate that statins have a moderate effect in improving the prognosis of ischemic stroke patients, underlying the possible complex role of statins in determining prognosis after ischemic stroke. Their data are in agreement with our preliminary results on the concurrent use of statins in patients with first-ever ischemic stroke.2 Previously, we found that the use of statins reduces the levels of C-reactive protein (CRP) after ischemic stroke, the initial neurological deficit, and improves the prognosis of stroke patients with a significant reduction of the 1-year risk of death or new vascular events.2 Recently, we have extended these observations in the same ischemic stroke cohort that had concluded the 2-year follow-up. All patients (n=193) were recruited in the period between March 1, 1998, and March 31, 1999. Design, methods, and baseline characteristics of our stroke data bank have been previously reported.3,4 We measured levels of CRP after stroke (within 24 hours), at 3 months, and at the end of the 2-year follow-up, together with total cholesterol, HDL and LDL subfractions, and triglycerides. Differences in proportions were evaluated by χ2 test. Continuous variables are described as mean±SD or median values with 25th and 75th percentiles, and comparisons between groups were evaluated with the Student t test or Mann-Whitney U test, when appropriate. The Kaplan-Meier technique (log-rank test) was applied in survival analysis. Log-normalized values of CRP were used to evaluate correlations over time. At the entry, mean total cholesterol concentrations were 4.62±1.25 mmol/L in men and 5.31±1.06 mmol/L …