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Vascular neurology
Effect of statin treatment on clinical outcomes in cardioembolic stroke with endovascular thrombectomy
  1. Chen Gong1,
  2. Chang Liu1,
  3. You Wang1,
  4. Liyuan Chen1,
  5. Jinxian Yuan1,
  6. Jie Zhang1,
  7. Li Xiaoming2,
  8. Yanru Chen1,
  9. Liping Huang1,
  10. Tao Xu1,
  11. Yangmei Chen1
  1. 1 Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
  2. 2 Department of Intensive Care Unit, Chongqing University Cancer Hospital, Chongqing, China
  1. Correspondence to Dr Yangmei Chen; chenym1997{at}cqmu.edu.cn; Dr Tao Xu; xutao{at}hospital.cqmu.edu.cn

Abstract

Background While statins have been widely used in patients with large-artery atherosclerotic stroke, their effectiveness in patients with cardioembolic large vessel occlusion (CE-LVO) undergoing endovascular treatment (EVT) remains unclear. This study aimed to evaluate whether combining statin therapy with EVT could improve clinical outcomes in patients with acute ischemic stroke caused by CE-LVO in the anterior circulation.

Methods We performed a retrospective screening on patients with CE-LVO in the anterior circulation who underwent EVT in 27 hospitals across China between 2018 and 2021. The primary outcome measure was functional independence, defined as a 90-day modified Rankin Scale (mRS) score of 0 to 2. Safety outcomes included 90-day mortality and symptomatic intracranial hemorrhage (sICH).

Results A total of 510 patients with CE-LVO in the anterior circulation undergoing EVT were included in this study. Of these, 404 (79.2%) patients received statin treatment (statin group), while 106 (20.8%) did not (non-statin group). Statin treatment was significantly associated with improved functional independence (adjusted OR (aOR) 2.072, 95% CI 1.197 to 3.586, P=0.009). Moreover, statin use was associated with a lower rate of 90-day mortality (aOR 0.343, 95% CI 0.197 to 0.596, P<0.001) and a lower rate of sICH (aOR 0.153, 95% CI 0.072 to 0.325, P<0.001).

Conclusion Statin treatment was associated with improved clinical outcomes and reduced risks of mortality and sICH in patients with CE-LVO in the anterior circulation undergoing EVT.

  • Thrombectomy
  • Stroke
  • Drug

Data availability statement

Data are available upon reasonable request. Datasets acquired and analyzed during the study are available from the corresponding author on request.

https://doi.org/10.1136/jnis-2023-020619

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    Data availability statement

    Data are available upon reasonable request. Datasets acquired and analyzed during the study are available from the corresponding author on request.

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    Footnotes

    • CG, CL, YW, LC and YC contributed equally.s

    • Contributors Design/conceptualisation of the study: YMC, TX. Analysis/data interpretation: CG, CL, YW, LYC. Drafting and revising the manuscript: CG, CL, TX, YMC. All authors gave final approval of the manuscript. YMC acts as the guarantor of the study.

    • Funding This work was supported by National Natural Science Foundation of China (No. 82001264), Chongqing Technology Innovation and Application Development Project (No. 2022TIAD-KPX0017).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.