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Abstract
Objective: To examine the potential efficacy of statin treatment in reducing the risk of poststroke seizures.
Methods: In this cohort study, patients with a first-ever ischemic stroke and no history of epilepsy before stroke were enrolled. After a mean follow-up period of 2.5 years, a follow-up assessment was performed to identify poststroke epilepsy. Logistic regression and Cox regression analyses were used to assess the relationship between statin use and poststroke early-onset seizures or poststroke epilepsy.
Results: Of 1,832 enrolled patients, 63 (3.4%) patients had poststroke early-onset seizures and 91 (5.0%) patients had poststroke epilepsy. Statin use was associated with a lower risk of poststroke early-onset seizures (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.20–0.60, p < 0.001), and this reduced risk was seen mainly in patients who used a statin only in the acute phase (OR 0.36, 95% CI 0.20–0.62, p < 0.001). No significant association was found between statin use and poststroke epilepsy (OR 0.81, 95% CI 0.52–1.26, p = 0.349). In 63 patients who presented with early-onset seizures, statin use was associated with reduced risk of poststroke epilepsy (OR 0.34, 95% CI 0.13–0.88, p = 0.026).
Conclusions: Statin use, especially in the acute phase, may reduce the risk of poststroke early-onset seizures. In addition, statin treatment may prevent the progression of initial poststroke seizure-induced neurodegeneration into chronic epilepsy. Because of the observational nature of the study, more studies are needed to confirm the results.
Classification of evidence: This study provides Class III evidence that in patients with a first-ever ischemic stroke, the early use of statins reduces the risk of early poststroke seizures.
GLOSSARY
- CI=
- confidence interval;
- ES=
- poststroke early-onset seizures;
- HDL-C=
- high-density lipoprotein cholesterol;
- NIHSS=
- NIH Stroke Scale;
- OR=
- odds ratio;
- PSE=
- poststroke epilepsy;
- TOAST=
- Trial of Org 10172 in Acute Stroke Treatment
Footnotes
↵* These authors contributed equally to this article.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 661
Supplemental data at Neurology.org
- Received December 6, 2014.
- Accepted in final form April 28, 2015.
- © 2015 American Academy of Neurology
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Letters: Rapid online correspondence
- The advantage of higher statin concentrations to improve outlook after ischemic stroke
- The relationship between ischemic stroke and seizures
- Statin treatment in acute ischemic stroke
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