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Statin Effects in Atrial Fibrillation-Related Stroke: A Systematic Review and Meta-Analysis
Background: Statins lower the risk of recurrent stroke and mortality and improve outcomes in patients with ischemic stroke. However, the effects of statins on atrial fibrillation (AF)-related stroke are not well-established. Our study aims to investigate the effects of statin therapy on the clinical...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581731/ https://www.ncbi.nlm.nih.gov/pubmed/33162931 http://dx.doi.org/10.3389/fneur.2020.589684 |
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author | Eun, Mi-Yeon Jung, Jin-Man Choi, Kang-Ho Seo, Woo-Keun |
author_facet | Eun, Mi-Yeon Jung, Jin-Man Choi, Kang-Ho Seo, Woo-Keun |
author_sort | Eun, Mi-Yeon |
collection | PubMed |
description | Background: Statins lower the risk of recurrent stroke and mortality and improve outcomes in patients with ischemic stroke. However, the effects of statins on atrial fibrillation (AF)-related stroke are not well-established. Our study aims to investigate the effects of statin therapy on the clinical outcomes in patients with AF-related stroke. Methods: Electronic databases (MEDLINE, Embase, and Scopus) were searched for previous studies on the effects of pre- and post-stroke statins on the clinical outcomes in AF-related stroke patients. The primary outcome was all-cause mortality. Secondary outcomes included recurrent ischemic stroke, acute coronary events, major adverse cardiovascular events (MACE), and short-term functional outcomes. We extracted hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (CI) from each study and pooled them through a meta-analysis. Results: A total of eight studies (five on post-stroke statins and three on pre-stroke statins) with 12,216 patients were included in the analysis. Post-stroke statin therapy reduced the risk of all-cause mortality (HR, 0.63; 95% CI, 0.55–0.74). This beneficial effect was sustained regardless of statin intensity. However, no significant associations were observed between statin therapy and a reduction in the risk of recurrent ischemic stroke, acute coronary events, or MACE. Pre-stroke statin use was associated with a lower risk of poor short-term functional outcomes (OR, 0.63; 95% CI, 0.47–0.85). Conclusions: Statin therapy for AF-related stroke may reduce all-cause mortality and improve functional outcomes. Randomized controlled studies are warranted to confirm the effects of statins on the outcomes of AF-related stroke. |
format | Online Article Text |
id | pubmed-7581731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75817312020-11-05 Statin Effects in Atrial Fibrillation-Related Stroke: A Systematic Review and Meta-Analysis Eun, Mi-Yeon Jung, Jin-Man Choi, Kang-Ho Seo, Woo-Keun Front Neurol Neurology Background: Statins lower the risk of recurrent stroke and mortality and improve outcomes in patients with ischemic stroke. However, the effects of statins on atrial fibrillation (AF)-related stroke are not well-established. Our study aims to investigate the effects of statin therapy on the clinical outcomes in patients with AF-related stroke. Methods: Electronic databases (MEDLINE, Embase, and Scopus) were searched for previous studies on the effects of pre- and post-stroke statins on the clinical outcomes in AF-related stroke patients. The primary outcome was all-cause mortality. Secondary outcomes included recurrent ischemic stroke, acute coronary events, major adverse cardiovascular events (MACE), and short-term functional outcomes. We extracted hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (CI) from each study and pooled them through a meta-analysis. Results: A total of eight studies (five on post-stroke statins and three on pre-stroke statins) with 12,216 patients were included in the analysis. Post-stroke statin therapy reduced the risk of all-cause mortality (HR, 0.63; 95% CI, 0.55–0.74). This beneficial effect was sustained regardless of statin intensity. However, no significant associations were observed between statin therapy and a reduction in the risk of recurrent ischemic stroke, acute coronary events, or MACE. Pre-stroke statin use was associated with a lower risk of poor short-term functional outcomes (OR, 0.63; 95% CI, 0.47–0.85). Conclusions: Statin therapy for AF-related stroke may reduce all-cause mortality and improve functional outcomes. Randomized controlled studies are warranted to confirm the effects of statins on the outcomes of AF-related stroke. Frontiers Media S.A. 2020-10-09 /pmc/articles/PMC7581731/ /pubmed/33162931 http://dx.doi.org/10.3389/fneur.2020.589684 Text en Copyright © 2020 Eun, Jung, Choi and Seo. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Eun, Mi-Yeon Jung, Jin-Man Choi, Kang-Ho Seo, Woo-Keun Statin Effects in Atrial Fibrillation-Related Stroke: A Systematic Review and Meta-Analysis |
title | Statin Effects in Atrial Fibrillation-Related Stroke: A Systematic Review and Meta-Analysis |
title_full | Statin Effects in Atrial Fibrillation-Related Stroke: A Systematic Review and Meta-Analysis |
title_fullStr | Statin Effects in Atrial Fibrillation-Related Stroke: A Systematic Review and Meta-Analysis |
title_full_unstemmed | Statin Effects in Atrial Fibrillation-Related Stroke: A Systematic Review and Meta-Analysis |
title_short | Statin Effects in Atrial Fibrillation-Related Stroke: A Systematic Review and Meta-Analysis |
title_sort | statin effects in atrial fibrillation-related stroke: a systematic review and meta-analysis |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581731/ https://www.ncbi.nlm.nih.gov/pubmed/33162931 http://dx.doi.org/10.3389/fneur.2020.589684 |
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