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Statin Effects in Atrial Fibrillation-Related Stroke: A Systematic Review and Meta-Analysis

Authors
Eun, Mi-YeonJung, Jin-ManChoi, Kang-HoSeo, Woo-Keun
Issue Date
9-10월-2020
Publisher
FRONTIERS MEDIA SA
Keywords
atrial fibrillation; statins; stroke; mortality; functional outcome; systematic review; meta-analysis
Citation
FRONTIERS IN NEUROLOGY, v.11
Indexed
SCIE
SCOPUS
Journal Title
FRONTIERS IN NEUROLOGY
Volume
11
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/52476
DOI
10.3389/fneur.2020.589684
ISSN
1664-2295
Abstract
Background:Statins lower the risk of recurrent stroke and mortality and improve outcomes in patients with ischemic stroke. However, the effects of statins on atrial fibrillation (AF)-related stroke are not well-established. Our study aims to investigate the effects of statin therapy on the clinical outcomes in patients with AF-related stroke. Methods:Electronic databases (MEDLINE, Embase, and Scopus) were searched for previous studies on the effects of pre- and post-stroke statins on the clinical outcomes in AF-related stroke patients. The primary outcome was all-cause mortality. Secondary outcomes included recurrent ischemic stroke, acute coronary events, major adverse cardiovascular events (MACE), and short-term functional outcomes. We extracted hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (CI) from each study and pooled them through a meta-analysis. Results:A total of eight studies (five on post-stroke statins and three on pre-stroke statins) with 12,216 patients were included in the analysis. Post-stroke statin therapy reduced the risk of all-cause mortality (HR, 0.63; 95% CI, 0.55-0.74). This beneficial effect was sustained regardless of statin intensity. However, no significant associations were observed between statin therapy and a reduction in the risk of recurrent ischemic stroke, acute coronary events, or MACE. Pre-stroke statin use was associated with a lower risk of poor short-term functional outcomes (OR, 0.63; 95% CI, 0.47-0.85). Conclusions:Statin therapy for AF-related stroke may reduce all-cause mortality and improve functional outcomes. Randomized controlled studies are warranted to confirm the effects of statins on the outcomes of AF-related stroke.
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