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.
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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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.
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