Rinsho Shinkeigaku (Clinical Neurology)

Original Article

Effects of statin use on intracranial hemorrhage and clinical outcome after intravenous rt-PA for acute ischemic stroke: SAMURAI rt-PA Registry

Noriko Makihara, M.D.1), Yasushi Okada, M.D.1), Masatoshi Koga, M.D.2), Yoshiaki Shiokawa, M.D.3), Jyoji Nakagawara, M.D.4), Eisuke Furui, M.D.5), Kazumi Kimura, M.D.6), Hiroshi Yamagami, M.D.7), Yasuhiro Hasegawa, M.D.8), Kazuomi Kario, M.D.9), Satoshi Okuda, M.D.10), Masaki Naganuma, M.D.2) and Kazunori Toyoda, M.D.2)

1)Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Center, National Hospital Organization Kyushu Medical Center2)Cerebrovascular Division, Department of Medicine, National Cardiovascular Center3)Department of Neurosurgery and Stroke Center, Kyorin University School of Medicine4)Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital5)Department of Stroke Neurology, Kohnan Hospital6)Department of Stroke Medicine, Kawasaki Medical School7)Department of Neurology, Stroke Center, Kobe City General Hospital8)Department of Neurology, St. Marianna University School of Medicine9)Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine10)Department of Neurology, National Hospital Organization Nagoya Medical Center

Purpose: We evaluated whether pre- and post-stroke statin use was associated with intracranial hemorrhage (ICH) and clinical outcome at 3 months after intravenous recombinant tissue plasminogen activator (IV rt-PA) for acute ischemic stroke.Methods: This study enrolled 600 consecutive patients (72±12 years, woman 37.2%) who received IV rt-PA at ten stroke centers that participated in the SAMURAI rt-PA Registry from October 2005 to July 2008.Results: Statins were used prior to stroke in 11.2% and within 72 h after IV rt-PA in 10.0% of patients. One hundred nineteen patients (19.8%) developed ICH. Pre-stroke statin use was not an independent factor associated with ICH (OR 1.46; 95%CI 0.76-2.81, p=0.225). Of 535 patients with a premorbid mRS≤1, 199 (37.2%) had a favorable clinical outcome at 3 months (mRS≤1). Pre-stroke statin use (OR 1.05; 95%CI 0.55-2.01, p=0.879), as well as post-stroke statin use (OR 1.31; 95%CI 0.66-2.59, p=0.440), was not an independent predictor of outcome.Conclusions: In patients who received IV rt-PA for acute ischemic stroke, statin use did not increase ICH after thrombolysis, nor was it associated with clinical outcome.
Full Text of this Article in Japanese PDF (420K)

(CLINICA NEUROL, 50: 225－231, 2010)
key words: brain infarction, thrombolysis, statin, dyslipidemia, intracranial hemorrhage

(Received: 19-Oct-09)