Supplementary Material for: Statin Use during Hospitalization and Short-Term Mortality in Acute Ischaemic Stroke with Chronic Kidney Disease

Objectives: Statin use during hospitalization improves prognosis in patients with ischaemic stroke. However, it remains uncertain whether acute ischaemic stroke patients with chronic kidney disease (CKD) benefit from statin therapy. We investigated the effect of statin use during hospitalization in reducing short-term mortality of patients with ischaemic stroke and CKD. Methods: Data of first-ever ischaemic stroke patients without a history of pre-stroke statin treatment was derived from the China National Stroke Registry. Patients were stratified according to estimated glomerular filtration rate (eGFR): normal renal function (eGFR ≥90 mL/min/1.73 m2), mild CKD (eGFR 60–90 mL/min/1.73 m2) and moderate CKD (eGFR < 60 mL/min/1.73 m2). Multivariate logistic regression analysis was used to evaluate the association between statin use during hospitalization and all-cause mortality with different renal functions at 3-month follow-up. Results: Among 5,951 patients included, 2,595 (43.6%) patients were on statin use during hospitalization after stroke (45.7% in patients with normal renal function, 42.0% in patients with mild CKD, and 39.0% in patients with moderate CKD). Compared with the non-statin group, statin use during hospitalization was associated with decreased all-cause mortality in patients with normal renal function (OR 0.65, 95% CI 0.43–0.97, p = 0.04), mild CKD (OR 0.59, 95% CI 0.38–0.91, p = 0.02) and moderate CKD (OR 0.41, 95% CI 0.23–0.75, p = 0.004) at 3-month follow-up. Conclusions: Statin use during hospitalization was associated with decreased 3-month mortality of ischaemic stroke patients with mild and moderate CKD. However, the conclusion should be confirmed in further studies with larger population, especially with moderate CKD.研究目的：住院期间使用他汀类药物可改善缺血性脑卒中患者的预后，但目前尚不明确合并慢性肾脏病（chronic kidney disease, CKD）的急性缺血性脑卒中患者是否能从他汀治疗中获益。本研究旨在探讨住院期间使用他汀类药物对合并缺血性脑卒中与慢性肾脏病的患者短期死亡率的影响。 研究方法：本研究数据来自中国国家卒中登记库（China National Stroke Registry），纳入对象为首次发生缺血性脑卒中且卒中前无他汀类药物治疗史的患者。根据估算肾小球滤过率（estimated glomerular filtration rate, eGFR）对患者进行分层：肾功能正常组（eGFR ≥90 mL/min/1.73 m²）、轻度慢性肾脏病组（eGFR 60~90 mL/min/1.73 m²）以及中度慢性肾脏病组（eGFR <60 mL/min/1.73 m²）。采用多因素logistic回归分析，评估不同肾功能分层患者住院期间使用他汀类药物与3个月随访时全因死亡率之间的关联。 研究结果：本研究共纳入5951例患者，其中2595例（43.6%）在卒中后住院期间接受了他汀类药物治疗（肾功能正常组占比45.7%，轻度慢性肾脏病组占比42.0%，中度慢性肾脏病组占比39.0%）。与未使用他汀类药物的患者相比，住院期间使用他汀类药物的患者在3个月随访时的全因死亡率显著降低：肾功能正常组（比值比OR=0.65，95%置信区间CI：0.43~0.97，p=0.04）、轻度慢性肾脏病组（OR=0.59，95%CI：0.38~0.91，p=0.02）以及中度慢性肾脏病组（OR=0.41，95%CI：0.23~0.75，p=0.004）。 研究结论：住院期间使用他汀类药物与合并轻度及中度慢性肾脏病的缺血性脑卒中患者3个月死亡率降低相关。但该结论仍需在更大样本量的研究中进一步验证，尤其是针对中度慢性肾脏病患者的亚组分析。