Association between statin treatment and outcomes among critically ill acute ischemic stroke patients

Objective

The efficacy of statin treatment in cerebrovascular neurocritical care is uncertain. We aimed to assess the association between statin treatment and outcomes among patients with acute ischemic stroke that are critically ill.

Methods

This study is a retrospective analysis of patients in the Medical Information Mart for Intensive Care IV database with acute ischemic stroke that required intensive care unit admission. The exposure variable was statin treatment in intensive care. The primary outcome was in-hospital mortality, and secondary outcomes were favorable discharge (either discharge to home or to acute rehabilitation) and intracranial hemorrhage. Multivariable binary logistic regression analyses were used to evaluate the association of statin treatment with outcomes.

Results

A total of 1551 patients (median age, 73 years; 49.5 % female) were enrolled, amongst which 874 patients (56.4 %) received statin treatment. After adjusting for potential confounders, statin treatment was associated with in-hospital mortality (OR 0.34, 95 %CI 0.25–0.48, p < 0.001) and favorable discharge (OR 1.72, 95 %CI 1.37–2.16, p < 0.001). Moreover, these associations were more pronounced in patients receiving intensive statin treatment compared to those receiving less–intensive statin therapy (mortality: OR 0.24 [95 %CI 0.15–0.37] vs. OR 0.50 [95 %CI 0.33–0.76], p for trend < 0.001; favorable discharge: OR 1.96 [95 %CI 1.51–2.54] vs. OR 1.40 [95 %CI 1.05–1.88], p for trend < 0.001). Statin treatment showed no significant association with intracranial hemorrhage (OR 0.95, 95 %CI 0.73–1.24, p = 0.701).

Conclusion

Statin treatment was associated with reduced in-hospital mortality and improved discharge outcomes in critically ill acute ischemic stroke patients, while showing no significant effect on intracranial hemorrhage, indicating its potential benefit and safety in this specific population.