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Statins May Improve Neurologic Outcomes After Ischemic Stroke: Presented at ISC

By Charlene Laino

SAN DIEGO, CA -- February 9, 2004 -- Statins appear to improve neurological outcomes after ischemic stroke, a new study finds.

Joan Montaner, MD, a neurologist at Vall d'Hebron Hospital in Barcelona, Spain, presented the study findings here on February 6^th at the American Stroke Association's 29^th International Stroke Conference (ISC).

Recent laboratory studies suggest that statin drugs appear to have neuroprotective properties, Dr. Montaner said. To test whether the findings extend to humans, the researchers designed a pilot, double-blinded, randomized, multicenter clinical trial of the safety and efficacy of simvastatin in the acute phase of ischemic stroke.

The study, known as Markers of Inflammation after Simvastatin in Ischemic Cortical Stroke ((MISTICS), enrolled 56 patients who had experienced strokes with cortical involvement and who had a National Institutes of Health Stroke Score (NIHSS) of 6 to 20. Between 3 hours and 12 hours from symptom onset, the patients were randomized to 40 mg daily of simvastatin until day 7, followed by 20 mg daily until day 90, or matching placebo.

The mean age of the patients, 51.8% of whom were male, was 73 years.

Nearly half (46.4%) of the patients given simvastatin showed significant neurological improvement by day 3, compared with 17.9% of those on placebo, the study showed.

By day 90, the mean decrease in NIHSS score was 9 points in the simvastatin arm versus 5 points in the placebo arm. Also, 10 patients in the statin arm showed "great improvement" -- defined as a decrease of more than 8 NIHSS points -- after 90 days, compared with 3 in the placebo arm.

Patients given simvastatin were 2.4 times more likely to develop infections, however, compared with placebo-treated patients (P < .05), the study showed.

"Initiating stains in the acute phase of ischemic stroke may improve neurological outcomes," Dr. Montaner said. "But why this improvement is accompanied by an increase in infections needs more study."


[Study title: Safety and Efficacy of Statins in the Acute Phase of Ischemic Stroke: the MISTICS Trial. Abstract P209]

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