Low dose statins improve prognosis of ischemic stroke patients with intravenous thrombolysis

Background: For acute ischaemic stroke patients, it is uncertain whether intravenous thrombolysis combined with statins might increase the therapeutic effect. Additionally, using high-intensity statins after thrombolysis may increase the risk of bleeding in patients. Asian stroke patients often take low-dose statins. It is speculated that reducing the dose of statins may improve the risk of bleeding. Methods: Data from consecutive acute ischaemic stroke patients with intravenous thrombolysis were prospectively collected. Efficacy outcomes included NIHSS (National Institutes of Health Stroke Scale) score improvement at 7 days after admission and mRS (Modified Rankin Scale) improvement at 90 days. Safety outcomes included haemorrhage events (intracerebral haemorrhage and gastrointestinal haemorrhage) in the hospital and death events within 2 years. Results: The study finally included 215 patients. The statin group had a higher percentage of NIHSS improvement at 7 days (p<0.001) and a higher percentage of a favourable functional outcome (FFO, mRS<=2) (p<0.001) at 90 days. The statin group had a lower percentage of intracerebral haemorrhage (p<0.001) and gastrointestinal haemorrhage (p=0.003) in the hospital and a lower percentage of death events (p<0.001) within 2 years. Logistic regression indicated that statin use was significantly related to NIHSS improvement (OR=4.697, p<0.001), a lower percentage of intracerebral haemorrhage (OR=0.372, p=0.049) and gastrointestinal haemorrhage (OR=0.023, p=0.016), and a lower percentage of death events (OR=0.072, p<0.001). Conclusion: For acute ischaemic stroke patients after intravenous thrombolysis, the use of low-dose statins was related to NIHSS improvement at 7 days and inversely related to haemorrhage events in the hospital and death events within 2 years, especially for moderate stroke or noncardioembolic stroke patients.