Abstract 66: Dynamics of Statin Use and Outcomes After Recanalization Treatment for Acute Ischemic Stroke When, How Much and for Whom?

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Introduction: Statin has the potential to be effective in the early phase of recanalization. However it is largely unknown in which group, when, and at what doses statin use is beneficial after recanalization.Methods: From a total of 7663 stroke cases of Seoul National University Bundang Hospital between July 2007 and Dec 2015, we collected eligible cases with the following inclusion criteria; (1) Lesion-documented ischemic stroke (N=6151); (2) received recanalization treatment (N=908). We excluded cases with missing in (1) the time information (N=26) and (2) modified Rankin Score (mRS) at 3 months (N=1). We gathered the exact timing, type, dose of statin use from a database of electronic bar-code medication administration system. Multivariable ordinal logistic regression was performed for mRS at 3 months (improved outcome).Results: Of the 881 analyzable cases (male, 58%; mean age, 68.9; median initial NIHSS score, 12), recanalization treatment consisted of 33% of IV-only, 33% of IA-only and 34% of combined IV-IA strategies. Stroke mechanisms were 26% of large artery atherosclerosis (LAA), 49% of cardioembolism (CE) and 25% of non-LAA/CE. Statins were administered in the acute phase (within 7 days) in 68% (n=598) patients (<24 hours in 35% [n=307] and 24-72 hours in 43% [n=170]). High intensity statins (atorvastatin 40-80 mg or rosuvastatin 20 mg) were used in 72% (n=429) and low-to-moderate intensity statins in 28% (n=169). Multivariable analyses revealed acute statin (within 7 days) was associated with improved outcome, especially in patients with IA treatment or when used within 24 hours. Low-to-moderate intensity statin was associated with improved outcome, but high intensity statin was not.Conclusions: Acute statin use after recanalization treatment may positively influence functional outcome, more in patients with IA treatment or when used within 24 hours. Low-to-moderate intensity statin may be as beneficial as high intensity statin after recanalization.

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