Background and Purpose—Renal dysfunction is associated with worse outcome in ischemic stroke. Dyslipidemia is a pronounced complication of renal dysfunction, and statin therapy is the major treatment. This study aimed to investigate the influence of statin therapy on the outcomes in ischemic stroke patients stratified by different renal function.
Methods—We evaluated the association between statins and 3-month outcomes according to baseline estimated glomerular filtration rate (eGFR, by CKD-EPI equation) in 50,092 patients with acute ischemic stroke from the Taiwan Stroke Registry during August 2006 to May 2016. Patients were categorized into 5 subgroups according to eGFR: ≥ 90, 60-89, 30-59, 15-29, and < 15 mL/min/1.73 m2. Outcomes were evaluated by mortality, modified Rankin scale, and recurrent ischemic stroke.
Results—Statin therapy was associated with lower risks of mortality (adjusted odds ratio [OR], 0.41; 95% confidence interval [CI], 0.34-0.50) and unfavorable outcomes (adjusted OR, 0.81; 95% CI, 0.77-0.85) at 3 months after ischemic stroke. After stratification by eGFR, the protective effect of statin therapy on mortality was only significant in patients with eGFR ≥ 15 mL/min/1.73 m2. Statin therapy was associated with lower risk of unfavorable outcome in all patients except those with eGFR between 15-29 mL/min/1.73 m2. In the eGFR group 60-89 mL/min/1.73 m2, statin use was associated with increased risk of recurrent ischemic stroke (adjusted HR = 1.29 [1.07-1.57]).
Conclusions—A protective effect of statins on short-term mortality in ischemic stroke was observed in patients with eGFR ≥ 15 mL/min/1.73 m2, and on functional outcome across all eGFR levels except for eGFR ranging from 15-29 mL/min/1.73 m2.

THE EFFECT OF STATINS ON THE OUTCOMES OF THE ISCHEMIC STROKE PATIENTS WITH RENAL DYSFUNCTION