LIPID PROFILE AND STATIN THERAPY IN PATIENTS WITH ATRIAL FIBRILLATION AND ACUTE ISCHEMIC STROKE RECEIVING ANTICOAGULANT THERAPY

Purpose: To evaluate the association of lipid profile and statin therapy with stroke severity and early functional outcome in anticoagulated patients with atrial fibrillation (AF) hospitalized with acute ischemic stroke (IS). Materials and methods: This prospective, single-center cohort study included consecutive patients with acute IS and documented AF who were receiving oral anticoagulant therapy prior to stroke onset, including direct oral anticoagulants or vitamin K antagonists with therapeutic INR values. Demographic characteristics, comorbidities, lipid profile, and clinical risk scores were recorded on admission. Stroke severity was assessed using the NIHSS, and early functional outcome was evaluated using the modified Rankin Scale at discharge. Results: A total of 55 patients were included (median age 79 years; 40% male). Prior statin therapy was identified in 40% of patients. Patients receiving statins had significantly lower LDL-C levels at admission. However, no significant differences were observed between statin-treated and non-treated patients regarding stroke severity, early functional outcome, or in-hospital mortality. Notably, statin-treated patients exhibited a higher baseline clinical risk profile, reflected by higher CHA2DS2-VASc and HAS-BLED scores and a greater prevalence of prior IS. Conclusion: In anticoagulated patients with AF presenting with acute IS, lipid profile and statin therapy were not primary determinants of early stroke severity or functional outcome. Comparable outcomes among statin-treated patients despite a higher baseline risk suggest that dyslipidemia may influence the clinical course of IS in a more indirect manner. This single-center study highlights the need for further investigation to clarify the role of lipid-related mechanisms beyond anticoagulation.