Statins' effect on quality of life and functioning in older stroke patients: Systematic review and meta-analysis.

Autor: Prins SR; Department of Neurology, Amsterdam UMC, Amsterdam, the Netherlands. Electronic address: s.r.prins@amsterdamumc.nl., Vermeer SE; Department of Neurology, Rijnstate Hospital, Arnhem, the Netherlands. Electronic address: svermeer@rijnstate.nl., Damoiseaux-Volman BA; Department of Medical Informatics, Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands. Electronic address: b.a.damoiseaux@amsterdamumc.nl., Priester-Vink S; Department of Research and Epidemiology, OLVG hospital, Amsterdam, the Netherlands. Electronic address: s.priester-vink@olvg.nl., Van der Velde N; Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands; Department of Internal Medicine, Subdepartment of Geriatrics, Amsterdam UMC, Amsterdam, The Netherlands. Electronic address: n.vandervelde@amsterdamumc.nl., Van den Berg-Vos RM; Department of Neurology, Amsterdam UMC, Amsterdam, the Netherlands; Department of Neurology, OLVG hospital, Amsterdam, The Netherlands. Electronic address: r.vandenberg-vos@olvg.nl.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2024 Dec 17; Vol. 132, pp. 110989. Date of Electronic Publication: 2024 Dec 17.
DOI: 10.1016/j.jocn.2024.110989
Abstrakt: Background: Limited evidence exists on the efficacy and safety of statins in older ischemic stroke or transient ischemic attack patients, particularly in frail individuals. Studies often exclude frail patients, limiting insights on optimal treatments for the entire older population. This review aims to evaluate the effect of statins for secondary prevention on quality of life and functioning in older patients following an ischemic stroke or transient ischemic attack, as these outcomes are aligned with the treatment goals of this patient population.
Methods: We performed a systematic review and meta-analysis by searching four major databases up to June 6th, 2023. Studies were included if they involved statins, assessed quality of life or functioning, focused on older patients, and addressed ischemic stroke or transient ischemic attack.
Findings: We included six randomized controlled trials and 16 cohort studies, totaling 66.273 patients. Mean or median age ranged from 65 to 79 years. Age ranges were not provided, and frailty status was not reported. One trial examined the effect of statins on QoL, yielding mixed results. Regarding the effect of statins on functioning, two trials reported positive effects, two found no effect, and two yielded mixed results. The meta-analysis of cohort studies indicated a positive association between statins and functioning (effect size: 0.43, CI 0.28-0.58). Methodological quality was poor, primarily due to confounding, participant selection and the allocation of patients into intervention groups.
Conclusion: We could not draw definitive conclusions regarding the effect of statins and QoL or functioning in older stroke patients. Mixed results were found in RCTs, and while a positive association between statins and functional outcome was observed in cohort studies, this should be interpreted with caution due to methodological limitations. Future research should focus on age-specific analyses and adequate representation of frail individuals to clarify this issue.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: