Background
Infection after stroke is common and likely detrimental. Given the potent immunomodulatory
properties of statins, we hypothesized that early statin use might increase the risk
of infection in the immediate post stroke period.
Methods
In a study cohort of 112 patients with ischemic stroke, we assessed the impact of
early statin use on the risk of post stroke infection.
Results
After controlling for stroke severity and patient age, the odds ratio (OR) and 95%
confidence interval (CI) for infection in the first 15 days after stroke among patients
on a statin by day 3 after stroke was 7.21 (95% CI 1.40-37.98; P = .018). When controlling for univariate predictors of infection, the OR associated
for infection associated with statin use actually increased, but was no longer significant
(8.49 [95% CI 0.92-77.98]; P = .059). In addition, early statin use was associated with an increase in plasma
interleukin-1 receptor antagonist (IL-1ra); IL-1ra was significantly higher in early
statin users than in nonstatin users by day 7 after stroke.
Conclusions
Our data suggest that early statin use appears to be associated with and increased
risk of post stroke infection. This risk may, in part, be related to increases in
plasma IL-1ra. If these findings are replicated in larger studies, they could have
important implications for the timing of statin therapy after stroke.
Key Words
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Article info
Publication history
Published online: July 22, 2011
Accepted:
June 13,
2011
Received in revised form:
May 26,
2011
Received:
March 5,
2011
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2011.06.008
Copyright
© 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.