Effects of early statin treatment on inflammatory biomarkers and clinical deterioration in patients with acute ischemic stroke

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  • Sakurai Kenzo
    Department of Neurology, St. Marianna University School of Medicine
  • Isahaya Kenji
    Department of Neurology, St. Marianna University School of Medicine
  • Takaishi Satoshi
    Department of Neurology, St. Marianna University School of Medicine
  • Kato Bunta
    Department of Neurology, St. Marianna University School of Medicine
  • Shimizu Kanako
    Department of Neurology, St. Marianna University School of Medicine
  • Shimomura Kana
    Department of Neurology, St. Marianna University School of Medicine
  • Tokuyama Yoshiaki
    Department of Neurology, St. Marianna University School of Medicine
  • Hasegawa Yasuhiro
    Department of Neurology, St. Marianna University School of Medicine

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Other Title
  • 脳梗塞急性期のスタチン投与が末梢血炎症性サイトカイン動態と急性期の進行増悪に与える影響
  • ノウコウソク キュウセイキ ノ スタチン トウヨ ガ マッショウケツ エンショウセイ サイトカイン ドウタイ ト キュウセイキ ノ シンコウ ゾウアク ニ アタエル エイキョウ

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Abstract

We prospectively studied the effects of early statin treatment on stroke-induced changes in the levels of inflammatory biomarkers. Patients admitted within 48 hours after the onset of ischemic stroke were enrolled. They were divided into 2 groups according to their lipid profiles and history of statin treatment. In patients who had received statin treatment prior to admission and those who had abnormal lipid profiles on admission, daily treatment with 10mg atorvastatin was initiated within 48 hours after the onset of stroke (Statin group; n=45). In patients who had normal lipid profiles on admission, statin was not administered for at least 2 weeks after admission (Non-Statin group; n=101). The serum concentrations of interleukin (IL)-6, IL-10, IL-18, matrix metalloproteinase (MMP)-2, MMP-9, and high sensitive C-reactive protein were measured on days 1, 3, 7, and 14. In percentage changes in serially measured circulating IL-6 levels, a significant interaction between group and repeated measures (group X time factor) was demonstrated (p=0.047). Frequency of neurological deterioration episodes (NIHSS score ≥2) during 14 days after admission was lower in the Statin group than in the Non-Statin group, however the difference did not reach statistically significant level (7.9% vs 20.2%, p=0.118). The initiation of usual dose of atorvastatin early after the onset of ischemic stroke significantly decreased the elevation of IL-6 and may protect against the early neurological deterioration. Circulating levels of IL-6 may be one of the candidates for monitoring the acute effects of statin. Further studies wherein IL-6 levels are monitored in larger samples would be feasible for investigating the effect of early treatment with usual dose of atorvastatin on the functional outcome.<br>

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