Neurology：卒中前应用他汀可改善老年患者短期转归

第65届美国神经病学学会（AAN2013）年会上公布的一项前瞻性究表明，在老年患者中，卒中前应用他汀类治疗与功能和认知改善具有显著相关性，但对死亡率和卒中复发率无影响。
　　尽管他汀类治疗可有效预防缺血性卒中，并且近期临床报告显示卒中前接受他汀类治疗可改善患者临床转归且死亡率降低，但老年患者的资料较为匮乏。该研究共纳入1053例老年缺血性卒中患者，并对人口统计学资料、主要血管危险因素和卒中1个月后转归进行了评估。
　　结果显示，受试者平均年龄为75±10岁，女性为57%，并且年龄大于80岁者占46%。主要血管危险因素为高血压（83%）、血脂异常（70%）、代谢综合征（46%）和肥胖（42%）。40%（409例）的患者在卒中前接受他汀类治疗。与卒中前未接受他汀类治疗的80岁以上患者相比，卒中发生1个月后接受他汀类治疗者的功能转归较高（m-Rankin <3：80%对70%；Barthel指数90 ± 16对85 ± 22），并且卒中后一个月认知功能亦较好（异常MMSE 20%对30%）。两组患者的死亡率和复发率无显著差异。
与卒中相关的拓展阅读：

• 维生素D缺乏卒中患者或更易他汀不耐受
• STROKE:较大量膳食纤维摄入或降低首次卒中危险
• Neurology：和肽素有助判断缺血性卒中的预后
• Stroke：血管内卒中治疗合用替罗非班增加脑出血风险
• Stroke：卒中后抑郁症长期复发风险高 更多信息请点击：有关卒中更多资讯

Neuroprotective Effect of Pre-Stroke Statin Therapy in a Cohort of Elderly Ischemic Stroke Patients (P03.195)
OBJECTIVE
We aimed to evaluate the association between statin use before stroke onset and short-term outcome in elderly patients with cerebral ischemic events.
BACKGROUND
Although statin therapy has shown to be effective in ischemic stroke prevention and recent clinical reports demonstrated better clinical outcomes and mortality reduction in patients under pre-stroke statin treatment, data in elderly patients are scarce.
DESIGN/METHODS
All ischemic stroke patients admitted to Hospital Italiano between January/ 2007 to April/ 2012 were prospectively included in the analysis, and demographic data, main vascular risk factors profile and control, and outcomes one month after stroke were evaluated.
RESULTS
1053 patients were included; mean age 75±10 years, 57% were female and 46% older than 80 years-old. Main vascular risk factors were hypertension (83%), dyslipemia (70%), metabolic syndrome (46%) and obesity (42%). Forty percent of patients were under statin treatment before stroke (n:409). Patients older than 80 years under statin treatment before stroke had better functional outcome than those who were not (m-Rankin <3: 80% vs 70%; Barthel index 90 ± 16 vs 85 ± 22) and better cognitive function one month after stroke (abnormal MMSE 20% vs 30%). There were no differences in mortality and recurrence rate between both groups.
CONCLUSIONS
Pre-stroke statin treatment is strongly associated with improved functionality and cognition in elderly patients. Mortality and recurrence rates were similar in all patients, independently of pre-stroke statin treatment.