Low-dose statin pretreatment reduces stroke severity and improves functional outcomes

Objectives Pre-stroke statin use reduces stroke severity and improves functional outcomes; however, whether low-dose statins as a primary preventive measure have similar effects on the Chinese population remains unclear. Methods Consecutive cases of ischaemic stroke between May 2011 and January 2017 were retrospectively analysed. The primary endpoints were stroke severity on admission and functional outcomes at 90 days. The secondary endpoints were factors related to lower stroke severity on admission. Propensity score matching and logistic regression analyses were performed. Results Of the 1878 patients, 6.4% and 23.8% were pre-stroke statin users before and after propensity matching, respectively, reducing the National Institutes of Health Stroke Scale (NIHSS) score on admission from 5 (2-9) to 3 (2-4) (P < 0.001). Patients receiving pretreatment with low-dose statins tended to have a better mRS distribution (median mRS score 2 [1-3] vs. 3 [2-4], P = 0.007) and a higher likelihood of favourable functional outcomes (FFOs) at 90 days (61 [65.6%] vs. 151 [50.8%], P = 0.005). The logistic regression analysis showed that low-dose statins taken before stroke (odds ratio [OR] = 0.15, 95% confidence interval [CI] = 0.08-0.27, P < 0.001) and being male (OR = 0.81, 95% CI = 0.66-0.99, P = 0.035) were related to a lower stroke severity on admission but not among patients with atrial fibrillation (OR = 1.65, 95% CI = 1.12-2.44, P = 0.012) or elevated white blood cell (WBC) counts (OR = 1.12, 95% CI = 1.08-1.17, P < 0.001). Conclusions Pretreatment with low-dose statins reduced initial stroke severity, improved functional outcomes at 90 days and was independently associated with a lower stroke severity on admission among Chinese patients.