ArticleFrontiers in neurology2026
Intensive versus standard statin therapy in acute ischemic stroke: a comparative study on the risk of pneumonia and multidrug-resistant bacterial infections.
Article in Frontiers in neurology, 2026. 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
Background: The use of intensive statin therapy in acute ischemic stroke (AIS) is common; however, its association with post-stroke pneumonia (PSP) remains uncertain. This study aimed to determine whether intensive-dose atorvastatin (≥40 mg/d) increases the risk, severity, or incidence of multidrug-resistant (MDR) bacterial infections in PSP compared to standard-dose therapy (20 mg/d). Methods: We retrospectively analyzed 4,843 AIS patients admitted to the First Affiliated Hospital of Wenzhou Medical University between January 2020 and January 2022. After applying inclusion and exclusion criteria, 3,199 patients were included. Propensity score matching (PSM) was used to balance baseline characteristics between the intensive and standard atorvastatin groups. The incidence of PSP, pneumonia severity (evaluated by CURB-65 scores), and MDR bacterial infection rates were compared. Multivariate logistic regression was applied to identify independent risk factors for PSP. Results: After PSM, no significant difference was observed in PSP incidence between the intensive and standard atorvastatin groups (8.8% vs. 8.3%, Conclusion: High-intensity atorvastatin therapy during the acute phase of ischemic stroke did not increase the risk or severity of pneumonia, nor did it elevate MDR bacterial infections. These findings suggest that intensive atorvastatin therapy is not associated with an increased risk of PSP and offer insights for optimizing clinical treatment strategies.
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