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Effect of Statin Administration After Onset of Acute Ischemic Stroke With Large Vessel Occlusion: Insights From RESCUE‐Japan Registry 2
BACKGROUND: Statins have been associated with reduced recurrence and better functional outcomes in patients with acute ischemic stroke. However, the effect of statins in patients with acute large vessel occlusion (LVO) is not well scrutinized. METHODS AND RESULTS: RESCUE (Recovery by Endovascular Sa...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763784/ https://www.ncbi.nlm.nih.gov/pubmed/33222618 http://dx.doi.org/10.1161/JAHA.120.017472 |
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author | Uchida, Kazutaka Yoshimura, Shinichi Imamura, Hirotoshi Ohara, Nobuyuki Sakai, Nobuyuki Tanaka, Kanta Yamagami, Hiroshi Matsumoto, Yasushi Takeuchi, Masataka Morimoto, Takeshi |
author_facet | Uchida, Kazutaka Yoshimura, Shinichi Imamura, Hirotoshi Ohara, Nobuyuki Sakai, Nobuyuki Tanaka, Kanta Yamagami, Hiroshi Matsumoto, Yasushi Takeuchi, Masataka Morimoto, Takeshi |
author_sort | Uchida, Kazutaka |
collection | PubMed |
description | BACKGROUND: Statins have been associated with reduced recurrence and better functional outcomes in patients with acute ischemic stroke. However, the effect of statins in patients with acute large vessel occlusion (LVO) is not well scrutinized. METHODS AND RESULTS: RESCUE (Recovery by Endovascular Salvage for Cerebral Ultra‐Acute Embolism)‐Japan Registry 2, a physician‐initiated registry, enrolled 2420 consecutive patients with acute LVO who were admitted to 46 centers across Japan within 24 hours of onset. We compared patients with and without statin use after acute LVO onset (statin group and nonstatin group, respectively) in terms of the modified Rankin scale at 90 days. We estimated that the odds ratios for the primary outcome was modified Rankin scale and we estimated the odds ratios for a 1‐scale lower modified Rankin scale adjusting for confounders. After excluding 12 patients without LVO and 9 patients without follow‐up, the mean age of 2399 patients was 75.9 years; men accounted for 55% of patients. Statins were administered to 447 (19%) patients after acute LVO onset. Patients in the statin group had more atherothrombotic cerebral infarctions (34.2% versus 12.1%, P<0.0001), younger age (73.4 years versus 76.5 years, P<0.0001), and lower median National Institutes of Health Stroke Scale on admission (14 versus 17, P<0.0001) than the nonstatin group. The adjusted common OR of the statin group for lower modified Rankin scale was 1.29 (95% CI, 1.04–1.37; P=0.02). The mortality at 90 days was lower in the statin group (4.7%) than the nonstatin group (12.5%; P<0.0001). The adjusted OR of the statin group relative to the nonstatin group for mortality was 0.36 (95% CI, 0.21–0.62; P=0.02). CONCLUSIONS: Statin administration after acute LVO onset is significantly associated with better functional outcome and mortality at 90 days. |
format | Online Article Text |
id | pubmed-7763784 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77637842020-12-28 Effect of Statin Administration After Onset of Acute Ischemic Stroke With Large Vessel Occlusion: Insights From RESCUE‐Japan Registry 2 Uchida, Kazutaka Yoshimura, Shinichi Imamura, Hirotoshi Ohara, Nobuyuki Sakai, Nobuyuki Tanaka, Kanta Yamagami, Hiroshi Matsumoto, Yasushi Takeuchi, Masataka Morimoto, Takeshi J Am Heart Assoc Original Research BACKGROUND: Statins have been associated with reduced recurrence and better functional outcomes in patients with acute ischemic stroke. However, the effect of statins in patients with acute large vessel occlusion (LVO) is not well scrutinized. METHODS AND RESULTS: RESCUE (Recovery by Endovascular Salvage for Cerebral Ultra‐Acute Embolism)‐Japan Registry 2, a physician‐initiated registry, enrolled 2420 consecutive patients with acute LVO who were admitted to 46 centers across Japan within 24 hours of onset. We compared patients with and without statin use after acute LVO onset (statin group and nonstatin group, respectively) in terms of the modified Rankin scale at 90 days. We estimated that the odds ratios for the primary outcome was modified Rankin scale and we estimated the odds ratios for a 1‐scale lower modified Rankin scale adjusting for confounders. After excluding 12 patients without LVO and 9 patients without follow‐up, the mean age of 2399 patients was 75.9 years; men accounted for 55% of patients. Statins were administered to 447 (19%) patients after acute LVO onset. Patients in the statin group had more atherothrombotic cerebral infarctions (34.2% versus 12.1%, P<0.0001), younger age (73.4 years versus 76.5 years, P<0.0001), and lower median National Institutes of Health Stroke Scale on admission (14 versus 17, P<0.0001) than the nonstatin group. The adjusted common OR of the statin group for lower modified Rankin scale was 1.29 (95% CI, 1.04–1.37; P=0.02). The mortality at 90 days was lower in the statin group (4.7%) than the nonstatin group (12.5%; P<0.0001). The adjusted OR of the statin group relative to the nonstatin group for mortality was 0.36 (95% CI, 0.21–0.62; P=0.02). CONCLUSIONS: Statin administration after acute LVO onset is significantly associated with better functional outcome and mortality at 90 days. John Wiley and Sons Inc. 2020-11-23 /pmc/articles/PMC7763784/ /pubmed/33222618 http://dx.doi.org/10.1161/JAHA.120.017472 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Uchida, Kazutaka Yoshimura, Shinichi Imamura, Hirotoshi Ohara, Nobuyuki Sakai, Nobuyuki Tanaka, Kanta Yamagami, Hiroshi Matsumoto, Yasushi Takeuchi, Masataka Morimoto, Takeshi Effect of Statin Administration After Onset of Acute Ischemic Stroke With Large Vessel Occlusion: Insights From RESCUE‐Japan Registry 2 |
title | Effect of Statin Administration After Onset of Acute Ischemic Stroke With Large Vessel Occlusion: Insights From RESCUE‐Japan Registry 2 |
title_full | Effect of Statin Administration After Onset of Acute Ischemic Stroke With Large Vessel Occlusion: Insights From RESCUE‐Japan Registry 2 |
title_fullStr | Effect of Statin Administration After Onset of Acute Ischemic Stroke With Large Vessel Occlusion: Insights From RESCUE‐Japan Registry 2 |
title_full_unstemmed | Effect of Statin Administration After Onset of Acute Ischemic Stroke With Large Vessel Occlusion: Insights From RESCUE‐Japan Registry 2 |
title_short | Effect of Statin Administration After Onset of Acute Ischemic Stroke With Large Vessel Occlusion: Insights From RESCUE‐Japan Registry 2 |
title_sort | effect of statin administration after onset of acute ischemic stroke with large vessel occlusion: insights from rescue‐japan registry 2 |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763784/ https://www.ncbi.nlm.nih.gov/pubmed/33222618 http://dx.doi.org/10.1161/JAHA.120.017472 |
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