Preferential effect of premorbid statins on atherothrombotic strokes through collateral circulation enhancement
European Neurology, 08/20/2012
Sargento–Freitas J et al. – Previous use of statins may preferentially benefit patients with atherothrombotic strokes by favoring the development of collateral pial circulation (CPC).Methods
- Consecutive patients receiving intra–arterial reperfusion therapy after an acute intracranial occlusion were analyzed.
- Premorbid use of antiplatelets, statins, oral antidiabetic drugs, antihypertensive drugs and oral anticoagulants were recorded.
- Collateral pial circulation (CPC) was scored on initial angiogram.
- 118 patients were included (mean age 70.4 ± 11 years, 45% female).
- 66 patients (56%) were cardioembolic, 30 (25%) atherothrombotic, and 22 (19%) other/unknown etiologies.
- No significant impact of medication was detected in all the series or cardioembolic strokes.
- However, relevant differences were found among atherothrombotic strokes.
- The previous use of antiplatelets was associated with smaller infarct volume (64 vs. 170 ml; p = 0.043) whereas premorbid statin predicted reduced infarct volume (64 vs. 215 ml; p = 0.019), clinical improvement (79 vs. 29%; p = 0.016) and good CPC (100 vs. 20%; p = 0.04).
- Statins were the only medication independently predicting reduced infarct volume and clinical improvement and this effect depended on CPC.