The effectiveness of hyperlipidemia treatment in strokes secondary prevention has been established. However, whether pretreatment with statins could confer protective effects when a patient's baseline low-density lipoprotein cholesterol (LDL-C) level is <70 mg/dL remains uncertain. Additionally, the ability of statin treatment to reduce poststroke complications, mortality, and recurrence in this patient group is unclear. In this retrospective observational study, we enrolled patients who had experienced an ischemic stroke with LDL-C levels <70 mg/dL. We analyzed the association of statin use with baseline characteristics, stroke severity, in-hospital complications, mortality rates, stroke recurrence rate, and mortality rate. Patients who used and patients who did not use statins were similar in terms of age and sex. Patients using statins had higher rates of diabetes mellitus, hypertension, prior stroke, and coronary artery disease but a lower incidence of atrial fibrillation. Stroke severity was less pronounced in those using statins. We also evaluated the relationship between in-hospital statin use and complications. We noted that in-hospital statin use was associated with lower rates of infection, hemorrhagic transformation, gastrointestinal hemorrhage, and mortality, as well as higher rates of positive functional outcomes. The 1-year recurrence rate was similar in both groups. Statin use is associated with milder strokes and improved poststroke outcomes, even in patients with well-controlled LDL levels. Neurologists may consider prescribing statins for patients with ischemic stroke who do not overt hyperlipidemia. Further research into potential underlying mechanisms is warranted.

中文翻译：

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他汀类药物治疗低密度脂蛋白胆固醇水平低于 70 mg/dL 的中风患者

高脂血症治疗在中风二级预防中的有效性已得到证实。然而，当患者的基线低密度脂蛋白胆固醇 (LDL-C) 水平<70 mg/dL 时，他汀类药物预处理是否可以产生保护作用仍不确定。此外，他汀类药物治疗降低该患者组中风后并发症、死亡率和复发的能力尚不清楚。在这项回顾性观察研究中，我们纳入了 LDL-C 水平<70 mg/dL 的缺血性中风患者。我们分析了他汀类药物使用与基线特征、卒中严重程度、院内并发症、死亡率、卒中复发率和死亡率的关联。使用他汀类药物的患者和未使用他汀类药物的患者在年龄和性别方面相似。使用他汀类药物的患者患糖尿病、高血压、既往中风和冠状动脉疾病的比率较高，但心房颤动的发生率较低。使用他汀类药物的患者中风严重程度不太明显。我们还评估了院内他汀类药物的使用与并发症之间的关系。我们注意到，院内使用他汀类药物与较低的感染率、出血性转化、胃肠道出血和死亡率以及较高的积极功能结果率相关。两组的 1 年复发率相似。他汀类药物的使用与轻度中风和改善中风后结局相关，即使对于低密度脂蛋白水平控制良好的患者也是如此。神经科医生可能会考虑为没有明显高脂血症的缺血性中风患者开他汀类药物。有必要进一步研究潜在的潜在机制。