Statin pre-treatment is associated with lower platelet activity and favorable outcome in patients with acute non-cardio-embolic ischemic stroke

This prospective study evaluated 172 patients with acute ischemic stroke divided in two groups: patients with pre-existing statin (n = 43) and without pre-existing statin (66 cases with statins initiated post-stroke and 63 without statin treatment). Platelet activation markers (CD62P and CD63) were measured by flow cytometry at different time points after stroke and analyzed with clinical outcome.The CD62P and CD63 expressions on platelets were significantly lower in the patients with pre-existing statin use compared to the patients without pre-existing statin use on Day 1 post-stroke (p < 0.05). The CD62P expression was significantly lower in the patients with pre-existing statin use on 90 days after the acute stroke (p < 0.05). Patients with pre-existing statin use had lower incidences of early neurologic deterioration (END) than those without treatment (p < 0.05). Among several baseline clinical variables, admission NIHSS score, history of coronary artery disease, and pre-existing statin use were independent predictions of good clinical outcome at three months.Pre-existing statin use is associated with decreased platelet activity as well as improved clinical outcome and reduced END in patients with acute ischemic stroke.Stroke is a major cause of morbidity and one of the leading causes of death worldwide [1]. Atherothrombosis and inflammation play important roles in the pathogenesis of acute ischemic stroke [2-4]. A previous study demonstrates that platelet activity, measured by CD62P and CD63 expressions on platelets, are increased after acute ischemic stroke and reduced in patients who receive anti-platelet therapy [5-7]. Anti-platelet drugs are the most commonly used drugs for secondary prevention after ischemic stroke of non-cardio-embolic origin [8], but their efficacy is not completely satisfactory [9,10].Statins, the 3-hydroxy 3-methyl-glutaryl coenzyme-A (HMG-CoA) reductase inhibitors, are medications originally used for the control of hypercholesterolemi