Abstract / Summary
Background High-intensity statins are the cornerstone for secondary prevention of stroke. Though proven to reduce the recurrence risk in non-cardioembolic strokes, higher doses are associated with increased risk of hemorrhagic stroke. Objective We studied the impact of atorvastatin at a dose of 40 mg/day on changes in the lipid profile, short-term functional status, and recurrence risk at 3 months after non-cardioembolic strokes. Methods This was a retrospective observational study of patients with acute ischemic stroke, with lacunar or large artery atherosclerosis as etiology. Patients were started on 40 mg of atorvastatin from the onset of stroke and followed up for 3 months. The lipid levels were collected at the time of admission and at 3-month follow-up, and their impact on stroke outcome and recurrence risk was analyzed. Results Of the 210 patients, etiology was lacunar in 161 (74.6%) and large artery atherosclerosis in 49 (25.4%) subjects. At admission, the median total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels were 189 mg/dL and 118 mg/dL, respectively. At the 90-day post-stroke follow-up, median LDL-C was 71 mg/dL with no reported discontinuation due to adverse effects. Lipid levels at baseline and 3 months did not impact recurrence risk or outcome. Conclusions Our findings indicate that medium-high intensity atorvastatin 40 mg/day can result in achieving LDL-C targets in over 80% of our stroke population without significant adverse effects, though it did not impact short-term functional outcome.