Characteristics of the patients
A total of 242 AIS patients with AF (118 men; 124 females) and 106 (43.80%) were assigned to the prestroke statins use group. The baseline characteristics of patients in the no prestroke statins use group (136) and prestroke statins use group (106) were compared (Table 1). At baseline, patients with prestroke statins use showed a significantly higher prevalence of hyperlipidemia than that in patients with no prestroke statins use (P<0.001). Patients with statins use showed significantly lower NIHSS score than patients with no statins use (P=0.041).
Plasma Ox-LDL level in the prestroke statins use and no prestroke statins use groups
Plasma Ox-LDL level was significantly lower in the prestroke statins use group on admission (33.53±5.53 vs 27.61±5.14, P=0.000). Compared with the baseline, Ox-LDL of the 3-month treatment period decreased both in two groups, the prestroke statins use group had lower Ox-LDL level(24.44±7.58 vs 29.28±6.03,P=0.000). Ox-LDL decreased about 27.11% in the prestroke statins use group, 22.14% in the no prestroke statin use group. The data showed significantly different Ox-LDL levels in the two groups at different time points.
Association Between Plasma Ox-LDL level and Prognosis
We also analyzed whether the plasma Ox-LDL level had effect on outcomes. 70 patients had died, and 86 patients had major disability on 3 months. The result demonstrated that plasma Ox-LDL level was significantly different between the outcome groups. Compared with the surviving patients, the patients who died had higher Ox-LDL level (37.95±5.63vs 34.96±5.48, P=0.000) on admission, and on 3 months (28.77±4.67vs 26.50±7.34, P = 0.039). Patients with major disability had higher Ox-LDL level than patients with good prognosis on admission (36.36±5.95vs 33.60±4.62, P = 0.004), there was no significant difference between two groups on 3 months (27.59±6.42 vs 25.44±8.03, P = 0.099).
Multivariable Models on the Association Between prestroke statins use and Death/Major disability
All patients with AF were followed up for 3 months. Seventy (70/242, 28.93%) patients had died, and they had a significantly higher NIHSS core on admission (13.43±6.42 vs 9.11±4.08, P<0.001) and were older (68.60±11.26 vs 65.73±9.74, P=0.022); a lower percentage had prestroke statins use [32.85% (23/70) vs 48.25% (83/172); OR, 0.53 (95% CI, 0.30-0.94); P=0.029].
In the multivariable logistic regression model, after adjustment for age, baseline NIHSS score, sex, BMI, hypertension, current smoking, current alcohol consumption, diabetes, hyperlipidemia, insular stroke, family history of stroke, and use of antihypertensive and warfarin medication, the 3-month mortality in the prestroke statins use group was lower than in the no prestroke statins use group (adjusted odds ratio, 0.43; 95% CI, 0.20-0.93; P=0.031).
In addition to the 70 deaths, of the remaining 172 patients, 83 patients were in the prestroke statins use group; 32 (32/83, 38.55%) patients had a major disability, which was a lower percentage than that in patients with no prestroke statins use (54/89, 60.67%); patients with 3-month major disability had a significantly higher NIHSS at admission (10.25±4.18 vs 7.95±3.67, P<0.001) than that in patients with a good prognosis.
In the multivariable logistic regression model after adjustment for age, baseline NIHSS score, sex, BMI, hypertension, current smoking, current alcohol consumption, diabetes, hyperlipidemia, family history of stroke, and use of antihypertensive and warfarin medication, there was an association between prestroke statins use and major disability (adjusted odds ratio, 0.33; 95% confidence interval, 0.13–0.82; P=0.017) and composite outcome (adjusted odds ratio, 0.25; 95% confidence interval, 0.11-0.56; P=0.001) (Table 2).