Statins Improve Outcomes in Acute Ischemic Atherothrombotic Stroke

MedicalResearch.com Interview with:

Georgios Tsivgoulis , M.D., Ph.D., MSc, FESO Assistant Professor of Neurology University of Athens, Athens, Greece Visiting Associate Professor of Neurology Director of Stroke Research Department of Neurology University of Tennessee Health Science Center

Dr. Georgios Tsivgoulis

Georgios Tsivgoulis , M.D., Ph.D., MSc, FESO
Assistant Professor of Neurology
University of Athens, Athens, Greece
Visiting Associate Professor of Neurology
Director of Stroke Research
Department of Neurology
University of Tennessee Health Science Center

Medical Research: What is the background for this study? What are the main findings?

Dr. Tsivgoulis: Literature data suggest that taking statins before an acute ischemic stroke may improve early outcomes including early neurological deterioration, mortality and disability in patients with acute ischemic stroke. However,the potential beneficial effect of statin pretreatment has never been investigated in acute ischemic stroke due to large artery atherosclerosis. The research question in this specific subgroup of ischemic stroke patients is of great importance, as large-artery atherosclerotic stroke carries the highest risk of early recurrent stroke in comparison to other acute ischemic stroke subtypes.

Using prospectively collected data from over 516 consecutive patients with acute large-artery atherosclerotic stroke from seven tertiary-care stroke centers during a three-year period we found that statin pretreatment in patients with acute large-artery atherosclerotic stroke is associated with better early outcomes in terms of neurological improvement, disability, survival and stroke recurrence.

Medical Research: What should clinicians and patients take away from your report?

Dr. TsivgoulisOur findings underscore a potentially beneficial effect of statins in improving early stroke outcomes in acute ischemic stroke patients with an underlying atherothrombotic mechanism and lend further support to current recommendations from the American Heart Association and the American Stroke Association for the management of acute ischemic stroke, which advocate continuation of statin treatment during hospitalization among acute ischemic stroke patients pretreated with statins.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Tsivgoulis:  Our hypothesis deserves to further be tested in the setting of a Randomized Clinical Trial. The ongoing Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis (CREST-2) will compare interventional therapy (endarterectomy or stenting) over best medical treatment in patients with significant (more than 70%), but asymptomatic, carotid artery stenosis. We believe that the role of statin pretreatment should be evaluated and further determined in the setting of this trial.

Citation:

Statin pretreatment is associated with better outcomes in large artery atherosclerotic stroke

Georgios Tsivgoulis, MD, Aristeidis H. Katsanos, MD, Vijay K. Sharma, MD, Christos Krogias, MD, Robert Mikulik, MD, Konstantinos Vadikolias, MD, Milija Mijajlovic, MD, Apostolos Safouris, MD, Christina Zompola, MD, Simon Faissner,Alexandrov, PhD, Konstantinos Voumvourakis, MD and Andrei V. Alexandrov, MD

Published online before print February 24, 2016doi:http:/​/​dx.​doi.​org/​10.​1212/​WNL.​0000000000002493Neurology 10.1212/WNL.0000000000002493

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Dr. Georgios Tsivgoulis (2016). Statins Improve Outcomes in Acute Ischemic Atherothrombotic Stroke MedicalResearch.com

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