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The efficacy and safety of high-dose statins in acute phase of ischemic stroke and transient ischemic attack: a systematic review

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Abstract

Inconsistent findings in the studies have been observed concerning the higher dose of statins use in the acute phase of ischemic stroke and transient ischemic attack (TIA). Therefore, we performed a systematic review to assess this issue. A computerized literature search in PubMed, Cochrane Library databases, and EMBASE for randomized controlled trials (RCTs) was conducted. The efficacy outcome indicators were National Institutes of Health Stroke Scale (NIHSS) score, infarct volume, and recurrence of stroke; the safety outcome indicators were intracranial hemorrhage events, cardiovascular and cerebrovascular events, and all-cause death. Pre-specified subgroup analyses were carried out. A total of seven RCTs with 1089 patients were included. Six studies reported the results of the NHISS score. A great reduction was found in NIHSS score in the statins group, and the difference is statistically significant [mean difference (MD) −1.15, 95% confidence interval (CI) −1.64 to −0.66, P < 0.00001]. However, no significant differences in the effect on recurrence of stroke [odds ratio (OR) 1.05, 95% CI 0.65–1.69, P = 0.85] (available in 3 studies), infarct volume [std. mean difference (SMD) 0.04, 95% CI −0.55 to 0.63, P = 0.89] (available in 2 studies), intracerebral hemorrhage events (OR 3.25, 95% CI 0.34–31.52, P = 0.31) (available in 2 studies), cardiovascular and cerebrovascular events (OR 0.70, 95% CI 0.35–1.43, P = 0.33) (available in 2 studies), and all-cause death (OR 1.18, 95% CI 0.60–2.35, P = 0.63) (available in 2 studies) were found. High-dose statin therapy in the acute phase of ischemic stroke and TIA significantly reduce the NIHSS score and improve short-term functional outcome without increasing related adverse events.

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Authors and Affiliations

  1. School of Life Sciences and Biopharmaceutis, Shenyang Pharmaceutical University, Shenyang, Liaoning, China

    Jing-xue Fang, Wei Wang & Yang Liu

  2. Department of Neurology, General Hospital of Shenyang Military Command, Shenyang, Liaoning, China

    Er-qiang Wang

  3. School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, China

    Gang Cheng

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  1. Jing-xue Fang
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Correspondence to Gang Cheng.

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All procedures in studies involving human participants are in accordance with the ethical standards of the institutional or national research committee and with the 1964 Helsinki declaration. This article does not contain any studies with animals performed by any of the author.

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Fang, Jx., Wang, Eq., Wang, W. et al. The efficacy and safety of high-dose statins in acute phase of ischemic stroke and transient ischemic attack: a systematic review. Intern Emerg Med 12, 679–687 (2017). https://doi.org/10.1007/s11739-017-1650-8

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