Statin treatment intensity and cerebral vasomotor reactivity response in patients with ischemic stroke

Author:

Sabayan Behnam12ORCID,Akhavan Sigari Amirhossein3,Modir Royya4,Meyer Brett C.4,Hemmen Thomas4,Meyer Dawn4,Bavarsad Shahripour Reza4

Affiliation:

1. Department of Neurology Hennepin Healthcare Research Institute Minneapolis Minnesota USA

2. Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis Minnesota USA

3. Department of Neurosurgery Stanford University School of Medicine Stanford California USA

4. UCSD Comprehensive Stroke Center Department of Neurosciences University of California San Diego California USA

Abstract

AbstractBackground and PurposeCerebral vasomotor reactivity (VMR) is vital for regulating brain blood flow and maintaining neurological function. Impaired cerebral VMR is linked to a higher risk of stroke and poor post‐stroke outcomes. This study explores the relationship between statin treatment intensity and VMR in patients with ischemic stroke.MethodsSeventy‐four consecutive patients (mean age 69.3 years, 59.4% male) with recent ischemic stroke were included. VMR levels were assessed 4 weeks after the index stroke using transcranial Doppler, measuring the breath‐holding index (BHI) as an indicator of the percentage increase in middle cerebral artery blood flow (higher BHI signifies higher VMR). Multistep multivariable regression models, adjusted for demographic and cerebrovascular risk factors, were employed to examine the association between statin intensity treatment and BHI levels.ResultsForty‐one patients (55%) received high‐intensity statins. Patients receiving high‐intensity statins exhibited a mean BHI of 0.85, whereas those on low‐intensity statins had a mean BHI of 0.67 (mean difference 0.18, 95% confidence interval: 0.13‐0.22, p‐value<.001). This significant difference persisted in the fully adjusted model (adjusted mean values: 0.84 vs. 0.68, p‐value: .008). No significant differences were observed in BHI values within patient groups on high‐intensity or low‐intensity statin therapy (all p‐values>.05). Furthermore, no significant association was found between baseline low‐density lipoprotein (LDL) levels and BHI.ConclusionsHigh‐intensity statin treatment post‐ischemic stroke is linked to elevated VMR independent of demographic and clinical characteristics, including baseline LDL level. Further research is needed to explore statin therapy's impact on preserving brain vascular function beyond lipid‐lowering effects.

Publisher

Wiley

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