The role of statins in cardioembolic stroke

Background: Statin therapy has become one of the most important advances in stroke secondary prevention. Nevertheless, statin therapy in patients with cardioembolic stroke has not been supported by clinical evidence yet. This study aimed to investigate the effect of statins on the neurological outcomes after a cardioembolic stroke. Methods: We conducted a prospective cohort study including consecutive patients with cardioembolic stroke. Subjects were classified into non-statin, simvastatin 20 mg, simvastatin 40 mg, and high potency statin groups. After 2 years, the functional outcome, stroke recurrence, major cardiovascular events, and mortality were assessed. Results: Among the 91 patients included in our cohort, there were 18 (19.8%) patients without statins, 30 (33.0%) with simvastatin 20 mg, 38 (41.7%) with simvastatin 40 mg and 5 (5.5%) with high-potency statins. Using simvastatin 40 mg was associated with a significantly lower incidence of stroke recurrence lower. Patients with simvastatin 40 mg and high-potency statins presented the best functional recovery throughout the follow-up (p < 0.01). Conclusions: The use of statins in patients with cardioembolic stroke may be beneficial in some cases, preventing stroke recurrence and improving functional outcomes. (C) 2019 Elsevier Ltd. All rights reserved.