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Published in: Critical Care 4/2011

Open Access 01-08-2011 | Research

Statin pre-treatment is associated with lower platelet activity and favorable outcome in patients with acute non-cardio-embolic ischemic stroke

Authors: Nai-Wen Tsai, Tsu-Kung Lin, Wen-Neng Chang, Chung-Ren Jan, Chi-Ren Huang, Shang-Der Chen, Kuei-Yueh Cheng, Yi-Fang Chiang, Hung-Chen Wang, Tzu-Ming Yang, Yu-Jun Lin, Wei-Che Lin, Hsueh-Wen Chang, Lian-Hui Lee, Cheng-Hsien Lu

Published in: Critical Care | Issue 4/2011

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Abstract

Introduction

Statins reportedly have anti-inflammatory and anti-thrombotic effects aside from cholesterol-lowering. This study aimed to evaluate the effect of pre-existing statin use on platelet activation markers and clinical outcome in acute ischemic stroke patients.

Methods

This prospective study evaluated 172 patients with acute ischemic stroke divided in two groups: patients with pre-existing statin (n = 43) and without pre-existing statin (66 cases with statins initiated post-stroke and 63 without statin treatment). Platelet activation markers (CD62P and CD63) were measured by flow cytometry at different time points after stroke and analyzed with clinical outcome.

Results

The CD62P and CD63 expressions on platelets were significantly lower in the patients with pre-existing statin use compared to the patients without pre-existing statin use on Day 1 post-stroke (p < 0.05). The CD62P expression was significantly lower in the patients with pre-existing statin use on 90 days after the acute stroke (p < 0.05). Patients with pre-existing statin use had lower incidences of early neurologic deterioration (END) than those without treatment (p < 0.05). Among several baseline clinical variables, admission NIHSS score, history of coronary artery disease, and pre-existing statin use were independent predictions of good clinical outcome at three months.

Conclusions

Pre-existing statin use is associated with decreased platelet activity as well as improved clinical outcome and reduced END in patients with acute ischemic stroke.
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Literature
1.
go back to reference Suwanwela N, Koroshetz WJ: Acute ischemic stroke: overview of recent therapeutic developments. Annu Rev Med. 2007, 58: 89-106. 10.1146/annurev.med.58.070605.115306.PubMedCrossRef Suwanwela N, Koroshetz WJ: Acute ischemic stroke: overview of recent therapeutic developments. Annu Rev Med. 2007, 58: 89-106. 10.1146/annurev.med.58.070605.115306.PubMedCrossRef
2.
3.
go back to reference Huang J, Upadhyay UM, Tamargo RJ: Inflammation in stroke and focal cerebral ischemia. Surg Neurol. 2006, 66: 232-245. 10.1016/j.surneu.2005.12.028.PubMedCrossRef Huang J, Upadhyay UM, Tamargo RJ: Inflammation in stroke and focal cerebral ischemia. Surg Neurol. 2006, 66: 232-245. 10.1016/j.surneu.2005.12.028.PubMedCrossRef
4.
go back to reference Tsai NW, Chang WN, Shaw CF, Jan CR, Huang CR, Chen SD, Chuang YC, Lee LH, Lu CH: The value of leukocyte adhesion molecules in patients after ischemic stroke. J Neurol. 2009, 256: 1296-1302. 10.1007/s00415-009-5117-3.PubMedCrossRef Tsai NW, Chang WN, Shaw CF, Jan CR, Huang CR, Chen SD, Chuang YC, Lee LH, Lu CH: The value of leukocyte adhesion molecules in patients after ischemic stroke. J Neurol. 2009, 256: 1296-1302. 10.1007/s00415-009-5117-3.PubMedCrossRef
5.
go back to reference Marquardt L, Ruf A, Mansmann U, Winter R, Schuler M, Buggle F, Mayer H, Grau AJ: Course of platelet activation markers after ischemic stroke. Stroke. 2002, 33: 2570-2574. 10.1161/01.STR.0000034398.34938.20.PubMedCrossRef Marquardt L, Ruf A, Mansmann U, Winter R, Schuler M, Buggle F, Mayer H, Grau AJ: Course of platelet activation markers after ischemic stroke. Stroke. 2002, 33: 2570-2574. 10.1161/01.STR.0000034398.34938.20.PubMedCrossRef
6.
go back to reference Cha JK, Jeong MH, Jang JY, Bae HR, Lim YJ, Kim JS, Kim SH, Kim JW: Serial measurement of surface expressions of CD63, P-selectin and CD40 ligand on platelets in atherosclerotic ischemic stroke. A possible role of CD40 ligand on platelets in atherosclerotic ischemic stroke. Cerebrovasc Dis. 2003, 16: 376-382. 10.1159/000072560.PubMedCrossRef Cha JK, Jeong MH, Jang JY, Bae HR, Lim YJ, Kim JS, Kim SH, Kim JW: Serial measurement of surface expressions of CD63, P-selectin and CD40 ligand on platelets in atherosclerotic ischemic stroke. A possible role of CD40 ligand on platelets in atherosclerotic ischemic stroke. Cerebrovasc Dis. 2003, 16: 376-382. 10.1159/000072560.PubMedCrossRef
7.
go back to reference Tsai NW, Chang WN, Shaw CF, Jan CR, Chang HW, Huang CR, Chen SD, Chuang YC, Lee LH, Lu CH: Serial change in platelet activation markers with aspirin and clopidogrel after acute ischemic stroke. Clin Neuropharmacol. 2010, 33: 40-45. 10.1097/WNF.0b013e3181b8abc6.PubMedCrossRef Tsai NW, Chang WN, Shaw CF, Jan CR, Chang HW, Huang CR, Chen SD, Chuang YC, Lee LH, Lu CH: Serial change in platelet activation markers with aspirin and clopidogrel after acute ischemic stroke. Clin Neuropharmacol. 2010, 33: 40-45. 10.1097/WNF.0b013e3181b8abc6.PubMedCrossRef
8.
go back to reference Hankey GJ: Secondary prevention of recurrent stroke. Stroke. 2005, 36: 218-221. 10.1161/01.STR.0000153048.87248.3b.PubMedCrossRef Hankey GJ: Secondary prevention of recurrent stroke. Stroke. 2005, 36: 218-221. 10.1161/01.STR.0000153048.87248.3b.PubMedCrossRef
9.
go back to reference van der Worp HB, van Gijn J: Clinical practice. Acute ischemic stroke. N Engl J Med. 2007, 357: 572-579. 10.1056/NEJMcp072057.PubMedCrossRef van der Worp HB, van Gijn J: Clinical practice. Acute ischemic stroke. N Engl J Med. 2007, 357: 572-579. 10.1056/NEJMcp072057.PubMedCrossRef
10.
go back to reference Goldstein LB, Adams R, Alberts MJ, Appel LJ, Brass LM, Bushnell CD, Culebras A, Degraba TJ, Gorelick PB, Guyton JR, Hart RG, Howard G, Kelly-Hayes M, Nixon JV, Sacco RL: Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006, 37: 1583-1633.PubMedCrossRef Goldstein LB, Adams R, Alberts MJ, Appel LJ, Brass LM, Bushnell CD, Culebras A, Degraba TJ, Gorelick PB, Guyton JR, Hart RG, Howard G, Kelly-Hayes M, Nixon JV, Sacco RL: Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006, 37: 1583-1633.PubMedCrossRef
11.
go back to reference Alberts AW: Discovery, biochemistry and biology of lovastatin. Am J Cardiol. 1988, 62: 10J-15J. 10.1016/0002-9149(88)90002-1.PubMedCrossRef Alberts AW: Discovery, biochemistry and biology of lovastatin. Am J Cardiol. 1988, 62: 10J-15J. 10.1016/0002-9149(88)90002-1.PubMedCrossRef
12.
go back to reference Kwak BR, Mach F: Statins inhibit leukocyte recruitment: new evidence for their anti-inflammatory properties. Arterioscler Thromb Vasc Biol. 2001, 21: 1256-1258.PubMed Kwak BR, Mach F: Statins inhibit leukocyte recruitment: new evidence for their anti-inflammatory properties. Arterioscler Thromb Vasc Biol. 2001, 21: 1256-1258.PubMed
13.
go back to reference Veillard NR, Mach F: Statins: the new aspirin?. Cell Mol Life Sci. 2002, 59: 1771-1786. 10.1007/PL00012505.PubMedCrossRef Veillard NR, Mach F: Statins: the new aspirin?. Cell Mol Life Sci. 2002, 59: 1771-1786. 10.1007/PL00012505.PubMedCrossRef
14.
go back to reference Tonkin A, John R: Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. N Engl J Med. 1998, 339: 1349-1357.CrossRef Tonkin A, John R: Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. N Engl J Med. 1998, 339: 1349-1357.CrossRef
15.
go back to reference Moonis M, Kane K, Schwiderski U, Sandage BW, Fisher M: HMG-CoA reductase inhibitors improve acute ischemic stroke outcome. Stroke. 2005, 36: 1298-1300. 10.1161/01.STR.0000165920.67784.58.PubMedCrossRef Moonis M, Kane K, Schwiderski U, Sandage BW, Fisher M: HMG-CoA reductase inhibitors improve acute ischemic stroke outcome. Stroke. 2005, 36: 1298-1300. 10.1161/01.STR.0000165920.67784.58.PubMedCrossRef
16.
go back to reference Amarenco P, Goldstein LB, Szarek M, Sillesen H, Rudolph AE, Callahan A, Hennerici M, Simunovic L, Zivin JA, Welch KM: Effects of intense low-density lipoprotein cholesterol reduction in patients with stroke or transient ischemic attack: the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Stroke. 2007, 38: 3198-3204. 10.1161/STROKEAHA.107.493106.PubMedCrossRef Amarenco P, Goldstein LB, Szarek M, Sillesen H, Rudolph AE, Callahan A, Hennerici M, Simunovic L, Zivin JA, Welch KM: Effects of intense low-density lipoprotein cholesterol reduction in patients with stroke or transient ischemic attack: the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Stroke. 2007, 38: 3198-3204. 10.1161/STROKEAHA.107.493106.PubMedCrossRef
17.
go back to reference Fonarow GC, Wright RS, Spencer FA, Fredrick PD, Dong W, Every N, French WJ: Effect of statin use within the first 24 hours of admission for acute myocardial infarction on early morbidity and mortality. Am J Cardiol. 2005, 96: 611-616. 10.1016/j.amjcard.2005.04.029.PubMedCrossRef Fonarow GC, Wright RS, Spencer FA, Fredrick PD, Dong W, Every N, French WJ: Effect of statin use within the first 24 hours of admission for acute myocardial infarction on early morbidity and mortality. Am J Cardiol. 2005, 96: 611-616. 10.1016/j.amjcard.2005.04.029.PubMedCrossRef
18.
go back to reference Marti-Fabregas J, Gomis M, Arboix A, Aleu A, Pagonabarraga J, Belvis R, Cocho D, Roquer J, Rodriguez A, Garcia M, Molina-Porcel L, Díaz-Manera J, Martí-Vilalta J-L: Favorable outcome of ischemic stroke in patients pretreated with statins. Stroke. 2004, 35: 1117-1121. 10.1161/01.STR.0000125863.93921.3f.PubMedCrossRef Marti-Fabregas J, Gomis M, Arboix A, Aleu A, Pagonabarraga J, Belvis R, Cocho D, Roquer J, Rodriguez A, Garcia M, Molina-Porcel L, Díaz-Manera J, Martí-Vilalta J-L: Favorable outcome of ischemic stroke in patients pretreated with statins. Stroke. 2004, 35: 1117-1121. 10.1161/01.STR.0000125863.93921.3f.PubMedCrossRef
19.
go back to reference Greisenegger S, Mullner M, Tentschert S, Lang W, Lalouschek W: Effect of pretreatment with statins on the severity of acute ischemic cerebrovascular events. J Neurol Sci. 2004, 221: 5-10. 10.1016/j.jns.2004.01.015.PubMedCrossRef Greisenegger S, Mullner M, Tentschert S, Lang W, Lalouschek W: Effect of pretreatment with statins on the severity of acute ischemic cerebrovascular events. J Neurol Sci. 2004, 221: 5-10. 10.1016/j.jns.2004.01.015.PubMedCrossRef
20.
go back to reference Leker RR, Khoury ST, Rafaeli G, Shwartz R, Eichel R, Tanne D: Prior use of statins improves outcome in patients with intracerebral hemorrhage: prospective data from the National Acute Stroke Israeli Surveys (NASIS). Stroke. 2009, 40: 2581-2584. 10.1161/STROKEAHA.108.546259.PubMedCrossRef Leker RR, Khoury ST, Rafaeli G, Shwartz R, Eichel R, Tanne D: Prior use of statins improves outcome in patients with intracerebral hemorrhage: prospective data from the National Acute Stroke Israeli Surveys (NASIS). Stroke. 2009, 40: 2581-2584. 10.1161/STROKEAHA.108.546259.PubMedCrossRef
21.
go back to reference Sacco RL, Adams R, Albers G, Alberts MJ, Benavente O, Furie K, Goldstein LB, Gorelick P, Halperin J, Harbaugh R, Johnston SC, Katzan I, Kelly-Hayes M, Kenton EJ, Marks M, Schwamm LH, Tomsick T: Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006, 37: 577-617. 10.1161/01.STR.0000199147.30016.74.PubMedCrossRef Sacco RL, Adams R, Albers G, Alberts MJ, Benavente O, Furie K, Goldstein LB, Gorelick P, Halperin J, Harbaugh R, Johnston SC, Katzan I, Kelly-Hayes M, Kenton EJ, Marks M, Schwamm LH, Tomsick T: Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006, 37: 577-617. 10.1161/01.STR.0000199147.30016.74.PubMedCrossRef
22.
go back to reference Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE: Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993, 24: 35-41. 10.1161/01.STR.24.1.35.PubMedCrossRef Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE: Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993, 24: 35-41. 10.1161/01.STR.24.1.35.PubMedCrossRef
23.
go back to reference Blanco M, Nombela F, Castellanos M, Rodriguez-Yanez M, Garcia-Gil M, Leira R, Lizasoain I, Serena J, Vivancos J, Moro MA, Dávalos A, Castillo J: Statin treatment withdrawal in ischemic stroke: a controlled randomized study. Neurology. 2007, 69: 904-910. 10.1212/01.wnl.0000269789.09277.47.PubMedCrossRef Blanco M, Nombela F, Castellanos M, Rodriguez-Yanez M, Garcia-Gil M, Leira R, Lizasoain I, Serena J, Vivancos J, Moro MA, Dávalos A, Castillo J: Statin treatment withdrawal in ischemic stroke: a controlled randomized study. Neurology. 2007, 69: 904-910. 10.1212/01.wnl.0000269789.09277.47.PubMedCrossRef
24.
go back to reference Lovblad KO, Baird AE: Computed tomography in acute ischemic stroke. Neuroradiology. 2010, 52: 175-187. 10.1007/s00234-009-0633-5.PubMedCrossRef Lovblad KO, Baird AE: Computed tomography in acute ischemic stroke. Neuroradiology. 2010, 52: 175-187. 10.1007/s00234-009-0633-5.PubMedCrossRef
25.
go back to reference Koh KK: Effects of statins on vascular wall: vasomotor function, inflammation, and plaque stability. Cardiovasc Res. 2000, 47: 648-657. 10.1016/S0008-6363(00)00146-2.PubMedCrossRef Koh KK: Effects of statins on vascular wall: vasomotor function, inflammation, and plaque stability. Cardiovasc Res. 2000, 47: 648-657. 10.1016/S0008-6363(00)00146-2.PubMedCrossRef
26.
go back to reference Schafer A, Fraccarollo D, Eigenthaler M, Tas P, Firnschild A, Frantz S, Ertl G, Bauersachs J: Rosuvastatin reduces platelet activation in heart failure: role of NO bioavailability. Arterioscler Thromb Vasc Biol. 2005, 25: 1071-1077. 10.1161/01.ATV.0000161926.43967.df.PubMedCrossRef Schafer A, Fraccarollo D, Eigenthaler M, Tas P, Firnschild A, Frantz S, Ertl G, Bauersachs J: Rosuvastatin reduces platelet activation in heart failure: role of NO bioavailability. Arterioscler Thromb Vasc Biol. 2005, 25: 1071-1077. 10.1161/01.ATV.0000161926.43967.df.PubMedCrossRef
27.
go back to reference Puccetti L, Pasqui AL, Pastorelli M, Bova G, Cercignani M, Palazzuoli A, Angori P, Auteri A, Bruni F: Time-dependent effect of statins on platelet function in hypercholesterolaemia. Eur J Clin Invest. 2002, 32: 901-908. 10.1046/j.1365-2362.2002.01086.x.PubMedCrossRef Puccetti L, Pasqui AL, Pastorelli M, Bova G, Cercignani M, Palazzuoli A, Angori P, Auteri A, Bruni F: Time-dependent effect of statins on platelet function in hypercholesterolaemia. Eur J Clin Invest. 2002, 32: 901-908. 10.1046/j.1365-2362.2002.01086.x.PubMedCrossRef
28.
go back to reference Lefer DJ: Statins as potent antiinflammatory drugs. Circulation. 2002, 106: 2041-2042. 10.1161/01.CIR.0000033635.42612.88.PubMedCrossRef Lefer DJ: Statins as potent antiinflammatory drugs. Circulation. 2002, 106: 2041-2042. 10.1161/01.CIR.0000033635.42612.88.PubMedCrossRef
29.
go back to reference Laufs U, Gertz K, Dirnagl U, Bohm M, Nickenig G, Endres M: Rosuvastatin, a new HMG-CoA reductase inhibitor, upregulates endothelial nitric oxide synthase and protects from ischemic stroke in mice. Brain Res. 2002, 942: 23-30. 10.1016/S0006-8993(02)02649-5.PubMedCrossRef Laufs U, Gertz K, Dirnagl U, Bohm M, Nickenig G, Endres M: Rosuvastatin, a new HMG-CoA reductase inhibitor, upregulates endothelial nitric oxide synthase and protects from ischemic stroke in mice. Brain Res. 2002, 942: 23-30. 10.1016/S0006-8993(02)02649-5.PubMedCrossRef
30.
go back to reference Htun P, Fateh-Moghadam S, Tomandl B, Handschu R, Klinger K, Stellos K, Garlichs C, Daniel W, Gawaz M: Course of platelet activation and platelet-leukocyte interaction in cerebrovascular ischemia. Stroke. 2006, 37: 2283-2287. 10.1161/01.STR.0000236638.75591.61.PubMedCrossRef Htun P, Fateh-Moghadam S, Tomandl B, Handschu R, Klinger K, Stellos K, Garlichs C, Daniel W, Gawaz M: Course of platelet activation and platelet-leukocyte interaction in cerebrovascular ischemia. Stroke. 2006, 37: 2283-2287. 10.1161/01.STR.0000236638.75591.61.PubMedCrossRef
31.
go back to reference Cipollone F, Mezzetti A, Porreca E, Di Febbo C, Nutini M, Fazia M, Falco A, Cuccurullo F, Davi G: Association between enhanced soluble CD40L and prothrombotic state in hypercholesterolemia: effects of statin therapy. Circulation. 2002, 106: 399-402. 10.1161/01.CIR.0000025419.95769.F0.PubMedCrossRef Cipollone F, Mezzetti A, Porreca E, Di Febbo C, Nutini M, Fazia M, Falco A, Cuccurullo F, Davi G: Association between enhanced soluble CD40L and prothrombotic state in hypercholesterolemia: effects of statin therapy. Circulation. 2002, 106: 399-402. 10.1161/01.CIR.0000025419.95769.F0.PubMedCrossRef
32.
go back to reference Crouse JR, Byington RP, Bond MG, Espeland MA, Craven TE, Sprinkle JW, McGovern ME, Furberg CD: Pravastatin, Lipids, and Atherosclerosis in the Carotid Arteries (PLAC-II). Am J Cardiol. 1995, 75: 455-459. 10.1016/S0002-9149(99)80580-3.PubMedCrossRef Crouse JR, Byington RP, Bond MG, Espeland MA, Craven TE, Sprinkle JW, McGovern ME, Furberg CD: Pravastatin, Lipids, and Atherosclerosis in the Carotid Arteries (PLAC-II). Am J Cardiol. 1995, 75: 455-459. 10.1016/S0002-9149(99)80580-3.PubMedCrossRef
33.
go back to reference Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ: Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008, 359: 2195-2207. 10.1056/NEJMoa0807646.PubMedCrossRef Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ: Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008, 359: 2195-2207. 10.1056/NEJMoa0807646.PubMedCrossRef
34.
go back to reference Gertz K, Laufs U, Lindauer U, Nickenig G, Bohm M, Dirnagl U, Endres M: Withdrawal of statin treatment abrogates stroke protection in mice. Stroke. 2003, 34: 551-557. 10.1161/01.STR.0000054055.28435.BF.PubMedCrossRef Gertz K, Laufs U, Lindauer U, Nickenig G, Bohm M, Dirnagl U, Endres M: Withdrawal of statin treatment abrogates stroke protection in mice. Stroke. 2003, 34: 551-557. 10.1161/01.STR.0000054055.28435.BF.PubMedCrossRef
35.
go back to reference Li JJ, Li YS, Chen J, Yang JQ: Rebound phenomenon of inflammatory response may be a major mechanism responsible for increased cardiovascular events after abrupt cessation of statin therapy. Med Hypotheses. 2006, 66: 1199-1204. 10.1016/j.mehy.2005.06.035.PubMedCrossRef Li JJ, Li YS, Chen J, Yang JQ: Rebound phenomenon of inflammatory response may be a major mechanism responsible for increased cardiovascular events after abrupt cessation of statin therapy. Med Hypotheses. 2006, 66: 1199-1204. 10.1016/j.mehy.2005.06.035.PubMedCrossRef
36.
go back to reference Yip HK, Liou CW, Chang HW, Lan MY, Liu JS, Chen MC: Link between platelet activity and outcomes after an ischemic stroke. Cerebrovasc Dis. 2005, 20: 120-128. 10.1159/000086802.PubMedCrossRef Yip HK, Liou CW, Chang HW, Lan MY, Liu JS, Chen MC: Link between platelet activity and outcomes after an ischemic stroke. Cerebrovasc Dis. 2005, 20: 120-128. 10.1159/000086802.PubMedCrossRef
37.
go back to reference Spencer CG, Gurney D, Blann AD, Beevers DG, Lip GY: Von Willebrand factor, soluble P-selectin, and target organ damage in hypertension: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Hypertension. 2002, 40: 61-66. 10.1161/01.HYP.0000022061.12297.2E.PubMedCrossRef Spencer CG, Gurney D, Blann AD, Beevers DG, Lip GY: Von Willebrand factor, soluble P-selectin, and target organ damage in hypertension: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Hypertension. 2002, 40: 61-66. 10.1161/01.HYP.0000022061.12297.2E.PubMedCrossRef
Metadata
Title
Statin pre-treatment is associated with lower platelet activity and favorable outcome in patients with acute non-cardio-embolic ischemic stroke
Authors
Nai-Wen Tsai
Tsu-Kung Lin
Wen-Neng Chang
Chung-Ren Jan
Chi-Ren Huang
Shang-Der Chen
Kuei-Yueh Cheng
Yi-Fang Chiang
Hung-Chen Wang
Tzu-Ming Yang
Yu-Jun Lin
Wei-Che Lin
Hsueh-Wen Chang
Lian-Hui Lee
Cheng-Hsien Lu
Publication date
01-08-2011
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2011
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc10303

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