For the patient on which I wrote my H&P, the attending added a statin to her treatment plan shortly after she was admitted to medicine. This surprised me because although the literature’s consensus is that statins are beneficial in post-stroke recovery and improved mortality after a stroke, I had never learned that statins were used in the treatment of acute ischemic stroke. I ultimately included a statin in my own plan despite not understanding the attending’s reasoning because I saw that her lipid panel reflected an LDL of 114 mg/dL, and also because she had a positive family history. But I still wanted to understand the evidence-based rationale for it.

This was the recent article I could find, and across 12,689 patients admitted with ischemic stroke to 17 hospitals, the authors found that statin administration before and during hospitalization for ischemic stroke was a crucial determinant of patient survival, and that early initiation and higher doses correlated with the most favorable outcomes. The results emphasize the significant impact of statin therapy on post-stroke survival, and highlight the nuanced relationship between statin use timing, dosage, and outcomes. They also found that the cessation of statin therapy during hospitalization is associated with worsened survival rates (even for short periods), emphasizing the importance of uninterrupted statin treatment in stroke care protocols. Although the study has its limitations (an observational design that leaves open the possibility of influential unmeasured variables, lack of important clinical data [e.g. National Institutes of Health Stroke Scale scores], and no attempt to address potential variations in statin types or dosages), the benefit of statin therapy in ischemic stroke management is not an acute indication, but rather to improve post-stroke recovery and mortality.