Background
Aspirin and statin are recommended for the treatment of acute ischemic stroke. However,
whether aspirin and statin pretreatment is associated with clinical outcomes has not
been well addressed. This study aimed to evaluate the effect of pre-existing statin
and aspirin use on platelet activation and clinical outcome in acute ischemic stroke
patients.
Methods
We conducted a prospective, multicenter observational study in patients with acute
ischemic stroke. Platelet aggregation and platelet–leukocyte aggregates were measured
on admission and during 7-10 days after admission. The primary outcome of the study
was neurological deterioration (ND) within 10 days after admission. The secondary
outcome was a composite of recurrent ischemic stroke, myocardial infarction, and death
during the first 3 months after admission. Physical disability was evaluated using
the modified Rankin Scale score at 3 months after admission.
Results
Among 1124 enrolled patients, 270 (24%) experienced ND. Higher platelet aggregation
and platelet–leukocyte aggregates on admission and during 7-10 days were associated
with ND. Platelet aggregation and platelet–leukocyte aggregates on admission were
significantly lower in the patients with pre-existing statin or aspirin use than those
without treatment. Patients with prestroke concomitant statin and aspirin treatment
had significantly lower incidence of ND than those without treatment. Diabetes mellitus,
fasting glucose, platelet–leukocyte aggregates, and prestroke concomitant statin and
aspirin use were independently associated with ND.
Conclusions
Prestroke concomitant statin and aspirin use is associated with lower neurological
deterioration and platelet activity in patients with acute ischemic stroke.
Key Words
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Article info
Publication history
Published online: October 25, 2016
Accepted:
September 22,
2016
Received in revised form:
August 21,
2016
Received:
July 24,
2016
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.030
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
