The advantage of higher statin concentrations to improve outlook after ischemic stroke
PrateushSingh, Doctor
Published September 25, 2015
We read with great interest the study by Guo et al., which explored the proposition that statin administration in the acute phase of first ever ischemic strokes reduces the risk of post-stroke early seizures (ES). [1] In addition to the cholesterol lowering cardiovascular benefits of statins, growing evidence supports an additional neuroprotective role via unknown pathophysiology. Other studies have illustrated the benefit conferred on long-term outlook post ischemic stroke by increased concentrations of statins. [2] It would be useful if Guo et al. deliberated whether higher concentrations of statins in the acute period post-stroke correlated with a further reduction in ES, and therein an improvement in long-term output as assessed, for example, by the modified Rankin score. Furthermore, statins vary in their lipophilic status and therefore their ability to cross the blood-brain barrier. A more lipophilic agent such as simvastatin may confer additional neuroprotective benefit at lower concentrations, reducing potential myopathic side effects while still reducing ES risk. [3]
1. Guo J, Guo J, Li J, al. Statin treatment reduces the risk of poststroke seizures. Neurology 2015; 85:701-707.
2. Tziomalos, K. et al. Comparative effects of more versus less aggressive treatment with statins on the long-term outcome of patients with acute ischemic stroke. Atherosclerosis 2015;243:65-70.
3. Banach M, Czuczwar SJ, Borowicz KK. Statins - are they anticonvulsant? Pharmacological reports 2014;66:521-528.
For disclosures, please contact the editorial office at journal@neurology.org.
We read with great interest the study by Guo et al., which explored the proposition that statin administration in the acute phase of first ever ischemic strokes reduces the risk of post-stroke early seizures (ES). [1] In addition to the cholesterol lowering cardiovascular benefits of statins, growing evidence supports an additional neuroprotective role via unknown pathophysiology. Other studies have illustrated the benefit conferred on long-term outlook post ischemic stroke by increased concentrations of statins. [2] It would be useful if Guo et al. deliberated whether higher concentrations of statins in the acute period post-stroke correlated with a further reduction in ES, and therein an improvement in long-term output as assessed, for example, by the modified Rankin score. Furthermore, statins vary in their lipophilic status and therefore their ability to cross the blood-brain barrier. A more lipophilic agent such as simvastatin may confer additional neuroprotective benefit at lower concentrations, reducing potential myopathic side effects while still reducing ES risk. [3]
1. Guo J, Guo J, Li J, al. Statin treatment reduces the risk of poststroke seizures. Neurology 2015; 85:701-707.
2. Tziomalos, K. et al. Comparative effects of more versus less aggressive treatment with statins on the long-term outcome of patients with acute ischemic stroke. Atherosclerosis 2015;243:65-70.
3. Banach M, Czuczwar SJ, Borowicz KK. Statins - are they anticonvulsant? Pharmacological reports 2014;66:521-528.
For disclosures, please contact the editorial office at journal@neurology.org.