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IV thrombolysis and statins

Lookup NU author(s): Professor Gary Ford


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Objective: To examine whether prior statin use affects outcome and intracranial hemorrhage (ICH) rates in stroke patients receiving IV thrombolysis (IVT). Methods: In a pooled observational study of 11 IVT databases, we compared outcomes between statin users and nonusers. Outcome measures were excellent 3-month outcome (modified Rankin scale 0-1) and ICH in 3 categories. We distinguished all ICHs (ICHall), symptomatic ICH based on the criteria of the ECASS-II trial (SICHECASS-II), and symptomatic ICH based on the criteria of the National Institute of Neurological Disorders and Stroke (NINDS) trial (SICHNINDS). Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals were calculated. Results: Among 4,012 IVT-treated patients, 918 (22.9%) were statin users. They were older, more often male, and more frequently had hypertension, hypercholesterolemia, diabetes, coronary heart disease, and concomitant antithrombotic use compared with nonusers. Fewer statin users (35.5%) than nonusers (39.7%) reached an excellent 3-month outcome (ORunadjusted 0.84 [0.72-0.98], p = 0.02). After adjustment for age, gender, blood pressure, time to thrombolysis, and stroke severity, the association was no longer significant (0.89 [0.74-1.06], p = 0.20). ICH occurred by trend more often in statin users (ICHall 20.1% vs 17.4%; SICHNINDS 9.2% vs 7.5%; SICHECASS-II 6.9% vs 5.1%). This difference was statistically significant only for SICHECASS-II (OR = 1.38 [1.02-1.87]). After adjustment for age, gender, blood pressure, use of antithrombotics, and stroke severity, the ORadjusted for each category of ICH (ICHall 1.15 [0.93-1.41]; SICHECASS-II 1.32 [0.94-1.85]; SICHNINDS 1.16 [0.87-1.56]) showed no difference between statin users and nonusers. Conclusion: In stroke patients receiving IVT, prior statin use was neither an independent predictor of functional outcome nor ICH. It may be considered as an indicator of baseline characteristics that are associated with a less favorable course. Neurology (R) 2011;77:888-895

Publication metadata

Author(s): Engelter ST, Soinne L, Ringleb P, Sarikaya H, Bordet R, Berrouschot J, Odier C, Arnold M, Ford GA, Pezzini A, Zini A, Rantanen K, Rocco A, Bonati LH, Kellert L, Strbian D, Stoll A, Meier N, Michel P, Baumgartner RW, Leys D, Tatlisumak T, Lyrer PA

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2011

Volume: 77

Issue: 9

Pages: 888-895

Print publication date: 01/08/2011

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins


DOI: 10.1212/WNL.0b013e31822c9135


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Funder referenceFunder name
Bayer Schering Pharma
Biocentrum Finland
Biocentrum Helsinki
Finnish Medical Foundation
German Neurological Society
Helsinki University Central Hospital (HUCH)
Liv och Halsa
Lundbeck Inc.
Shire plc
Swiss Academy of Medical Sciences
Swiss Cardiology Foundation
Swiss National Foundation
Boehringer Ingelheim
European Union
Finnish Academy of Sciences
foundation of CHUM (Centre Hospitalier Universitaire de Montreal)
German Research Foundation
Innovative Medicines Initiative (European Federation of Pharmaceutical Industries and Associations)
Innovative Medicines Initiative (European Union)
International Vascular Workshop
Maire Taponen Foundation
Pfizer Inc
Sigrid Juselius Foundation
Swiss Heart Foundation
Swiss National Funds
Swiss National Science Foundation
PHRC 2008/1901French Health Ministry