Efficacy of Statin therapy in post-stroke seizure prophylaxis: Clues from an observational study of routine secondary prevention treatment

Purpose: To confirm that statin use can reduce the risk of post-stroke seizures (PSS), and to further investigate the association between the details of specific statin therapy, including the initial time, types, doses, courses, and the risk of PSS. Methods: Patients with newly-onset ischemic stroke and no history of epilepsy before stroke were enrolled. After an average of 2 years follow-up, with the aim of establishing a PSS diagnosis, logistic regression was utilized to assess the association between specific statin therapy and the risk of PSS. Results: Of 1051 enrolled patients, 24 (2.3%) developed early-onset seizures (ES) and 38 (3.6%) had late-onset seizures (LS), 28 of whom had LS twice or more, and thus fell in the category of post-stroke epilepsy (PSE) patients. Statin therapy was associated with a lower risk of ES (P = 0.009), LS (P = 0.007), and PSE (P = 0.009), and this reduction was even more pronounced in patients using intensive-dose statins (ES [P = 0.003], LS [P = 0.004], PSE [P = 0.006]). In addition, the risk of PSE was significantly reduced in long-course statin therapy compared with short-course statin therapy (P = 0.015). However, no significant association was found between the initial time of treatment and PSS risk (ES [P = 0.321], LS [P = 0.050], PSE [P = 0.108]). Conclusions: Statin treatment, especially with intensive-dose statins, can reduce the risk of PSS. In addition, the risk of developing PSE appears to be significantly lower for prolonged statin treatment. However, due to the observational nature of this study, more investigations are warranted to confirm its findings.