No abstract

Pretreatment with statins is associated with lower stroke severity, at high as well as at low to moderate doses.

In young patients with ischemic stroke, migraine may be associated with a higher frequency of HS.

OBJECTIVE: To examine the effect of pre-treatment with statins, at high (80 mg) and non-high (<80 mg) doses, on ischemic stroke (IS) severity in clinical practice. METHODS: prospective study of IS admissions to our Stroke Unit during a 3-year period (2008-2010). Demographic data, vascular risk factors, previous treatments (statins, ACE inhibitors, ARB, antithrombotic drugs), stroke severity (NIHSS), stroke subtype, in-hospital complications, length of stay and functional status at discharge (mRS) were collected. Mild stroke severity was defined as NIHSS <=5 on admission. Good outcome was defined as mRS <= 2 at discharge. Multivariable regression models and matched propensity score analyses were used to quantify the association of statins pretreatment, at high and non-high doses, with a mild stroke severity. RESULTS: Of 969 IS patients, 23% were using non-high doses and 4.1% high doses of statins before the stroke event. Statins were associated with lower NIHSS scores on admission (median [IQR], 4 [9] for non-statins patients; 4 [9] for non-high doses of statins and 2 [4] for high doses of statins; p =0.010). The frequency of mild stroke on admission was higher in the statin groups (57.9% for non-statins, 63.2% for non-high doses of statins and 77.5% for high doses of statins, p =0.026). High doses of statins were related with favourable outcomes at discharge, although this was not statistically significant (66.6% for non-statins group, 64.7% for non-high doses of statins and 75% for high doses of statins, p =0.443). After multivariable adjustment, pretreatment with statins was associated with higher odds of mild stroke severity and this effect was greater at high doses (OR=1.637, 95% CI 1.156-2.319 for the non-high doses and OR=3.297, 95% CI 1.480-7.345, for the high doses of statins). CONCLUSION: Petreatment with statins is associated with lower stroke severity and this effect could be greater at higher doses.