Statin therapy and outcome after ischemic stroke: systematic review and meta-analysis of observational studies and randomized trials
| العنوان: | Statin therapy and outcome after ischemic stroke: systematic review and meta-analysis of observational studies and randomized trials |
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| المؤلفون: | Niamh Hannon, Natalia S. Rost, Stefan T. Engelter, Peter J. Kelly, Amanda G. Thrift, Haralampos J. Milionis, Joan Montaner, Mario Di Napoli, Elisa Cuadrado-Godia, Exuperio Díez-Tejedor, Elizabeth Callaly, Joan Martí-Fàbregas, Antonio Muscari, Sotirios Giannopoulos, Konstantinos Vemmos, Signild Åsberg, Karen L. Furie, Danielle Ní Chróinín, Slaven Pikija, Patricia Martínez-Sánchez, Moira K. Kapral, Antonio M. Gotto, Kjell Asplund, Frederik Jonsson, Jeffrey L. Probstfield |
| المساهمون: | NÍ CHRÓINÍN D, ASPLUND K, ASBERG S, CALLALY E, CUADRADO-GODIA E, DÍEZ-TEJEDOR E, DI NAPOLI M, ENGELTER ST, FURIE KL, GIANNOPOULOS S, GOTTO AM JR, HANNON N, JONSSON F, KAPRAL MK, MARTÍ-FÀBREGAS J, MARTÍNEZ-SÁNCHEZ P, MILIONIS HJ, MONTANER J, MUSCARI A, PIKIJA S, PROBSTFIELD J, ROST NS, THRIFT AG, VEMMOS K, KELLY PJ |
| المصدر: | STROKE r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | medicine.medical_specialty, Ischemia, MEDLINE, ischemia, Outcome (game theory), law.invention, Brain Ischemia, Randomized controlled trial, law, Internal medicine, medicine, STATINS, Humans, Thrombolytic Therapy, cardiovascular diseases, Stroke, Randomized Controlled Trials as Topic, Advanced and Specialized Nursing, therapy, Cerebral infarction, business.industry, neuroprotective agents, medicine.disease, cerebral infarction, stroke, meta-analysis, outcomes assessment, Treatment Outcome, Meta-analysis, cebral infarction, Physical therapy, Observational study, Neurology (clinical), Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Background and Purpose— Although experimental data suggest that statin therapy may improve neurological outcome after acute cerebral ischemia, the results from clinical studies are conflicting. We performed a systematic review and meta-analysis investigating the relationship between statin therapy and outcome after ischemic stroke. Methods— The primary analysis investigated statin therapy at stroke onset (prestroke statin use) and good functional outcome (modified Rankin score 0 to 2) and death. Secondary analyses included the following: (1) acute poststroke statin therapy (≤72 hours after stroke), and (2) thrombolysis-treated patients. Results— The primary analysis included 113 148 subjects (27 studies). Among observational studies, statin treatment at stroke onset was associated with good functional outcome at 90 days (pooled odds ratio [OR], 1.41; 95% confidence interval [CI], 1.29–1.56; P P =0.31), and with reduced fatality at 90 days (pooled OR, 0.71; 95% CI, 0.62–0.82; P P =0.01). In the single randomized controlled trial reporting 90-day functional outcome, statin treatment was associated with good outcome (OR, 1.5; 95% CI, 1.0–2.24; P =0.05). No reduction in fatality was observed on meta-analysis of data from 3 randomized controlled trials ( P =0.9). In studies restricted to of thrombolysis-treated patients, an association between statins and increased fatality at 90 days was observed (pooled OR, 1.25; 95% CI, 1.02–1.52; P =0.03, 3 studies, 4339 patients). However, this association was no longer present after adjusting for age and stroke severity in the largest study (adjusted OR, 1.14; 95% CI, 0.90–1.44; 4012 patients). Conclusion— In the largest meta-analysis to date, statin therapy at stroke onset was associated with improved outcome, a finding not observed in studies restricted to thrombolysis-treated patients. Randomized trials of statin therapy in acute ischemic stroke are needed. |
| وصف الملف: | STAMPA |
| تدمد: | 1524-4628 0039-2499 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::791897affecea6b299153394e31cb2b0Test https://pubmed.ncbi.nlm.nih.gov/25255603Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....791897affecea6b299153394e31cb2b0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244628 00392499 |
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