Stroke: intensive statin therapy effectively stabilises intracranial atherosclerotic plaque

  • Chung JW & al.
  • J Neurol Neurosurg Psychiatry
  • 1 Aug 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.


  • In patients with acute ischaemic stroke (AIS) and intracranial atherosclerotic disease (ICAD), high-dose statin therapy effectively stabilises symptomatic intracranial atherosclerotic plaques on serial high-resolution magnetic resonance imaging (HR-MRI) at 6 months.

Why this matters

  • Pre-stroke statin use has been reported to modify plaque enhancement in symptomatic intracranial atherosclerosis.
  • However, limited evidence exists over the long-term effects of high-dose statin treatment on the stabilisation of vulnerable intracranial plaques.

Study design

  • The Intensive Statin Treatment in Acute Ischaemic Stroke Patients with Intracranial Atherosclerosis – HR-MRI (STAMINA-MRI), a single arm observational study included 77 patients with AIS and ICAD on high dose statin therapy.
  • Primary outcomes: changes in stenosis degree, remodelling and wall area index and enhancement volume of atherosclerotic plaque on HR-MRI before and after 6 months of statin therapy.
  • Funding: Samsung Medical Center and Dong-A Pharma, Inc. Seoul, South Korea.

Key results

  • After 6 months of follow-up, high-dose statin therapy significantly reduced:
    • total cholesterol (123.20±24.53 mg/dL; P<.001>
    • triglyceride (121.85±53.28 mg/dL; P=.003),
    • low-density lipoprotein cholesterol (LDL-C; 60.95±19.28 mg/dL; P<.001>
    • non-high-density lipoprotein cholesterol (73.7±21.0 mg/dL; P<.001 and>
    • apolipoprotein B (63.73±16.73; P<.001>
  • After 6 months, statin therapy significantly reduced the wall area index (5.86±4.04; P=.016), stenosis degree (64.05±1.29%; P<.001 and enhancement volume of atherosclerotic plaque mm>3; P=.013) but not the remodelling index (P=.195).
  • 35% of patients showed no change or increase in enhancement volume and stenosis degree after statin therapy.
  • Higher reduction of LDL-C level and longer duration of therapy were associated with a reduction in enhancement volume after statin therapy.


  • Single-centre study with a small sample size.
  • Significant variation in the time interval between initial and follow-up HR-MRIs.