ABSTRACT NUMBER: ESOC2026A954 IMPACT OF STATIN THERAPY ON POST-STROKE EPILEPSY (PSE): AN EMERGING ANTI-EPILEPTOGENIC STRATEGY

Abstract Background and aims Growing evidence supports the hypothesis that statin therapy in patients with acute stroke may reduce the risk of post-stroke epilepsy through pleiotropic mechanisms. This study aimed to evaluate factors associated with the development of post-stroke epilepsy (PSE), with a focus on the potential role of statin therapy, in a real-world cohort of stroke patients. Methods Clinical and radiological data of 777 consecutive patients with acute stroke were retrospectively analyzed. Data of patient with PSE and without PSE were compared. Univariate and multivariate logistic regression analysis was conducted to identify variables associated with the development of PSE. Results The two groups did not differ significantly with respect to demographic characteristics or comorbidities, the median NIHSS score at admission was significantly higher in the post-stroke epilepsy (PSE) group than in the non-PSE group (12 vs. 6, p < 0.001). Multivariate analysis showed that higher NIHSS scores at admission (OR = 1.004, 95% CI: 1.002–1.007; p = 0.001) and the occurrence of early seizures or early status epilepticus (ES/ESE) (OR = 1.112, 95% CI: 1.042–1.187; p < 0.001) were independently associated with an increased risk of PSE, while statin therapy emerged as an independent protective factor against PSE development (OR = 0.948, 95% CI: 0.915–0.999; p = 0.048). Conclusions In a consecutive cohort of acute stroke patients, statin therapy emerged as an independent protective factor against the development of PSE, underscoring its potential role in antiepileptogenic processes. Conflict of interest Edoardo Ricci: Nothing to disclose. Giovanni Furlanis: Nothing to disclose. Milos Ajčević: Nothing to disclose. Katerina Iscra: Nothing to disclose. Michele Malesani: Nothing to disclose. Magda Quagliotto: Nothing to disclose. Gianpiero Farina: Nothing to disclose.Paola Caruso: Nothing to disclose. Marcello Naccarato: Nothing to disclose. Paolo Manganotti: Nothing to disclose. Table 1 - belongs to Results Table 2 - belongs to Conclusions