Abstract / Summary
Abstract Background Post-stroke cognitive impairment (PSCI) lacks established treatment protocols. This study evaluated the efficacy of probucol combined with atorvastatin on cognitive function after acute ischemic stroke and compared assessment methods for cognitive impairment. Patients and methods A total of 81 patients with acute ischemic stroke admitted to the Affiliated Hospital of Chengde Medical College between November 2020 and May 2021 were enrolled in this study. Using a random number table method, they were divided into probucol combined with atorvastatin ( n = 40) and atorvastatin ( n = 41) groups. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and blood lipid levels were assessed 6 months after treatment and compared between the two groups. Chi-square tests were used to compare the rate differences between the experimental groups, and a multifactor generalized estimation equation was used to analyze the factors influencing the MoCA scale results. To explore potential effect modifiers, we conducted a subgroup analysis restricted to participants with cognitive impairment at baseline. Results Cognitive impairment was observed in 60.5% (49/81) of patients in the acute phase. At 6 months, the prevalence decreased to 39.5% (32/81), with significant differences between the combination therapy group (27.5%, 11/40) and the atorvastatin-only group (51.2%, 21/41) ( P = 0.029). Total cholesterol and LDL levels decreased significantly in both groups ( P < 0.05). Multivariate analysis indicated that previous cerebrovascular history, treatment phase, combination therapy, infarct area, and LDL levels were significant predictors of cognitive outcome ( P < 0.05). Subgroup analysis showed that patients with baseline cognitive impairment, age >60 years, or prior stroke history derived greater benefit from combination therapy ( P < 0.05 for interaction). Conclusion Probucol combined with atorvastatin was significantly associated with improved cognitive outcomes in patients with acute ischemic stroke, with exploratory subgroup analyses suggesting enhanced effects in those with baseline cognitive impairment, older age, or previous stroke. This combination appears clinically promising for PSCI management, though these preliminary findings require confirmation in larger trials. Trial registration Chinese Clinical Trial Registry (ChiCTR2000040461) registered time:2020-11-28