Statin use and lipid profile in relation to safety and functional outcome after thrombolysis in ischemic stroke

Evaluation of: Rocco A, Sykora M, Ringleb P, Diedler J. Impact of statin use and lipid profile on symptomatic intracerebral haemorrhage, outcome and mortality after intravenous thrombolysis in acute stroke. Cerebrovasc. Dis. 33(4), 362-368 (2012). Statins are widely used in the primary and secondary prevention of cardiovascular disease and prevent first and recurrent ischemic strokes mainly because of their lipid-lowering effect. However, they also have pleiotropic effects and might be neuroprotective in acute ischemic stroke. Improved functional outcome in patients with acute ischemic stroke treated with intravenous thrombolysis tissue plasminogen activator has been proposed, but not confirmed by other studies. Furthermore, some studies showed an increased risk of symptomatic intracranial hemorrhage in statin users. The article being evaluated presents a large observational cohort of acute ischemic stroke patients treated with intravenous tissue plasminogen activator and showed no association between statin use or lipid profiles and functional outcome or risk of symptomatic intracranial hemorrhage. The results of this article are discussed in the context of previous published studies.