Table 2.
Summary of statins clinical trials in stroke severity and functional outcomes.
| Trials [Reference] | Inclusion Criteria | Statins | Dose (mg/d) | Control Group | Evaluation Criteria | Efficiency | Administration Time |
|---|---|---|---|---|---|---|---|
| MISTICS [83] | Cortical stroke | Simvastatin | 40 | Placebo | NIHSS | (46.4% vs. 17.9％, P = 0.022) by the third day |
3 - 12 h from symptom onset |
| North Dublin Study [84] |
Acute ischemic stroke |
Atorvastatin Pravastatin |
10 - 80 10 - 40 |
Statins-untreated | Decreased fatality | OR = 0.48; P = 0.05 at 1 year, OR = 0.23; P = 0.002 at 90 days, OR = 0.04; P = 0.003 at 7 days |
Pre-stroke |
| OR = 0.26; P < 0.001 at 1 year,
OR = 0.19; P < 0.001 at 90 days, OR = 0.12; P = 0.006 at 7 days |
Acute post-stroke (< 72 h) | ||||||
| Functional outcome (mRS 0 - 2) |
OR = 1.41; P = 0.37 at 1 year, OR = 2.21; P = 0.05 at 90 days, OR = 2.15; P = 0.07 at 7 days |
Pre-stroke | |||||
| OR = 1.69; P = 0.14 at 1 year, OR = 1.88; P = 0.09 at 90 days, OR = 2.06; P = 0.06 at 7 days |
Acute post-stroke (< 72 h) | ||||||
| Statins withdrawal for functional outcome [87] |
Hemispheric ischemic stroke within 24 h |
Statins withdrawal group | --- | Atorvastatin 20mg/d | mRS > 2 | OR = 4.66; P < 0.05 | Withdrawal for first 3 days after admission |
| END | OR = 8.7; P = 0.002 |
||||||
| Mean infarct volume | 63 ml (SE 10.01; P < 0.001) | ||||||
| Statins withdrawal for poststroke survival [88] | Acute ischemic stroke |
Statins prescription | --- | Statins use both before and during hospitalization | Poststroke survival | HR = 2.5; P < 0.001 | Withdrawal in hospital |
| No statins use before and during hospitalization | HR = 0.55; P < 0.001 | Initiation in the hospital | |||||
| No statins use before hospitalization | HR = 0.85; P < 0.001 | Before ischemic stroke | |||||
| No statins use before and during hospitalization | HR = 0.59; P < 0.001 | Before and during hospitalization | |||||
| Prestroke statins for initial severity [81] | Ischemic stroke | High dose (rosuvastatin; any other statins) |
40 80 |
No statins use | Mild stroke severity (NIHSS ≤ 5) |
OR = 3.297; 95% CI: 1.480 - 7.345 | Pre-stroke |
| Low to moderate dose | Stroke severity (NIHSS) |
Median [interquartile range]: 2 [4] P = 0.010 |
|||||
| Low to moderate dose (rosuvastatin; any other statins) | 0 - 40 0 - 80 |
No statins use | Mild stroke severity (NIHSS ≤ 5) | OR = 1.637; 95% CI: 1.156 - 2.319 | |||
| High dose | Stroke severity (NIHSS) | Median [interquartile range]: 4 [9] P = 0.010 |
|||||
| Prestroke statins on severity and outcome [82] | First-ever ischemic stroke |
Statins users | Non-statins users | Functional outcome (mRS) | OR = 0.76; P = 0.221 | Use before onset | |
| Initial severity (NIHSS) | Median[interquartile range]4 [7] versus 4 [9] P = 0.104 |
Note: HR = hazard ratio; ND = early neurological deterioration; mRS = modified Rankin Scale; NIHSS = national institute of health stroke scale; OR = odds ratio.