Abstract TP033: Impact of prior statin use in patients with acute stroke with LDL < 70 mg/dl

Introduction: Current stroke guidelines emphasize risk reduction through lifestyle changes, diabetes and hypertension management, and smoking cessation. The AHA recommends assessing ASCVD risk in individuals aged 40–75, with statin therapy advised for those at borderline or intermediate risk to achieve LDL levels under 100 mg/dL, aiming to reduce cardiovascular morbidity and mortality. For patients with prior cardiovascular events, the target LDL is under 70 mg/dL. This study examines stroke patients with baseline LDL <70 mg/dL to evaluate the impact of statins on post-stroke disability outcomes. Methods: Our Stroke center maintains a registry of acute ischemic stroke patients with an admission LDL <70mg/dl who are longitudinally followed for any vascular outcomes over 5 years. Patients baseline characteristics including NIHSS on admission, therapeutics and mRS/mortality are collected. Data was analyzed using R studio. We present the preliminary baseline observations and analysis of impact of prior statins on stroke severity and post stroke disability. Results: We analyzed 243 stroke patients (Jan 2021–June 2024) with LDL <70 mg/dL; 42% had prior statin use. The cohort had a mean age of 68.7 years (SD 13.6), was 50% female, 60% Hispanic, and 33% African American. Common comorbidities included HTN (85%), DM (56%), CAD (23%), and COPD/asthma (19%); 21% had prior stroke/TIA, and 18% had substance use. Median hospital stay was 5 days (IQR 3–10), and median NIHSS was 4 (IQR 1–11). Stroke types were thrombotic (63%), TIA (23%), and ICH (14%), with a discharge median mRS of 3 (IQR 1–4) and 5% in-hospital mortality. No association was found between prior statin use and stroke type or severity using a multinomial regression model. However, CAD was linked to higher odds of thrombotic stroke (OR 4.96) and TIA (OR 5.40) vs. ICH. Age was associated with increased odds of TIA (OR 1.04), while HTN was linked to lower odds of TIA (OR 0.14). Prior statin use did not correlate with stroke severity (NIHSS) or disability (mRS) after adjusting for key covariates. Conclusion: Our data indicates that prior statin use in patients with acute stroke and LDL <70 mg/dL is not associated with stroke severity or disability at discharge, contrary to our initial hypothesis. This finding highlights the need to explore other contributing factors or interventions that may enhance outcomes and lower the risk of future cardiovascular events, especially in individuals with a history of such events.