ArticleCNS neuroscience & therapeutics2025
Assessment of the Impact of Statin Use to Predict All-Cause Mortality in Patients With Critical Cerebrovascular Disease: A Retrospective Cohort Study From the MIMIC-IV Database.
Article in CNS neuroscience & therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe impact of statin therapy on short-term mortality among critically ill patients with hemorrhagic stroke or ischemic stroke remains uncertain. We investigated associations between statin use and ICU and hospital mortality in this patient population.
methodsWe conducted a retrospective cohort study using the MIMIC-IV database, including 6918 patients (2960 HS and 3958 IS) after applying strict exclusion criteria. Statin use was assessed by type, dose (standard vs. high), and initiation timing (pre-ICU vs. post-ICU). Survival outcomes were evaluated using Kaplan-Meier analysis and multivariable Cox regression models, landmark analyses, and Fine-Gray competing-risk models, with propensity score matching to adjust for confounding factors.
resultsStatin use significantly reduced ICU mortality at 30 days in HS (HR = 0.59, 95% CI: 0.41-0.87) and IS (HR = 0.45, 95% CI: 0.32-0.64) cohorts. Atorvastatin and simvastatin showed pronounced protective effects, independent of dose intensity. Post-ICU initiation of statins conferred greater benefit compared with pre-ICU initiation, especially in HS patients. Shorter statin treatment duration (≥ 3 days) sufficiently captured beneficial effects. Patients with hyperlipidemia demonstrated enhanced mortality benefit.
conclusionStatin use is associated with significantly lower short-term mortality in critically ill stroke patients, supporting tailored strategies for optimal statin initiation and duration.
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