Effect of different doses of atorvastatin on early neurological deterioration and short-term outcomes in patients with acute ischemic stroke / 国际脑血管病杂志

ABSTRACT

Objective To intestate the effect of different doses of atorvastatin on early neurological deterioration and short-term outcomes in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled prospectively.They were randomly assigned to either a standard therapy group (atorvastatin 20 mg/d) or an intensive treatment group (atorvastatin 40 mg/d).The primary outcomes were early neurological deterioration within 1 week of treatment and the good outcome of evaluation at 1 month after treatment (the modified Rankin Scale score 0-2); the secondary outcomes were the National Institutes of Health Stroke Scale (NIHSS) score and adverse events at 1 month.Results A total of 125 patients with acute ischemic stroke were enrolled,including 62 in the standard therapy group and 63 in the intensive treatment group.The incidence of early neurological deterioration at 1 week after treatment in the standard therapy group was significantly higher than that in the intensive treatment group (16.13％ vs.4.76％;x2=4.333,P=0.038); the proportion of good outcome in the standard therapy group was significantly lower than that in the intensive treatment group at 1 month after treatment (53.23％ vs.71.43％ ;x2 =4.413,P=0.036).During the treatment,no significant liver damage,muscle toxicity and other adverse events of causing atorvastatin reduction or withdrawal occurred in the patients of both groups.Conclusions Using high-dose atorvastatin in the acute phase of ischemic stroke may decrease the incidence of early neurological deterioration compared with the conventional dose,and improve short-term clinical outcomes.