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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2026, vol. 32, issue2
Subject Area: Medicine
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DOI: 10.5272/jimab.2026322.6792
Published online: 02 April 2026
Original article
J of IMAB. 2026 Apr-Jun;32(2):6792-6796
LIPID PROFILE AND STATIN THERAPY IN PATIENTS WITH ATRIAL FIBRILLATION AND ACUTE ISCHEMIC STROKE RECEIVING ANTICOAGULANT THERAPY
Veronika Vasileva
, Maya Danovska, Yoanna Todorova, Georgi Dimitrov, Diana Marinova,
Department of Neurology, University Hospital, Medical University, Pleven, Bulgaria.
ABSTRACT:
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.
Keywords: Atrial fibrillation, stroke, anticoagulant therapy, statins, lipids,
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Please cite this article as: Vasileva V, Danovska M, Todorova Y, Dimitrov G, Marinova D. Lipid profile and statin therapy in patients with atrial fibrillation and acute ischemic stroke receiving anticoagulant therapy. J of IMAB. 2026 Apr-Jun;32(2):6792-6796. [Crossref - 10.5272/jimab.2026322.6792]
Correspondence to: Veronika Vasileva, Neurology Clinic, UMHAT “Dr Georgi Stranski” Pleven; 8A, Georgi Kochev Str., Pleven 5800, Bulgaria; E-mail: veronika_vasileva1@abv.bg
REFERENCES:
1. Shweikialrefaee B, Ko DT, Fang J, Pang A, Austin PC, Dorian P, et al. Statin Use and Stroke Rate in Older Adults With Atrial Fibrillation: A Population Based Cohort Study. J Am Heart Assoc. 2023 Jun 20;12(12):e028381. [PubMed]
2. Van Gelder IC, Rienstra M, Bunting KV, Casado-Arroyo R, Caso V, Crijns HJGM, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024 Sep 29;45(36):3314–414. [PubMed]
3. Lee M, Cheng CY, Wu YL, Lee JD, Hsu CY, Ovbiagele B. Association Between Intensity of Low-Density Lipoprotein Cholesterol Reduction With Statin-Based Therapies and Secondary Stroke Prevention: A Meta-analysis of Randomized Clinical Trials. JAMA Neurol. 2022 Apr 1;79(4):349. [PubMed]
4. Hindy G, Engström G, Larsson SC, Traylor M, Markus HS, Melander O, et al. Role of Blood Lipids in the Development of Ischemic Stroke and its Subtypes: A Mendelian Randomization Study. Stroke. 2018 Apr;49(4):820-7. [PubMed]
5. Cholesterol Treatment Trialists’ (Ctt) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomized trials. The Lancet. 2010 Nov;376(9753):1670–81. [PubMed]
6. Ding WY, Protty MB, Davies IG, Lip GYH. Relationship between lipoproteins, thrombosis, and atrial fibrillation. Cardiovasc Res. 2022 Feb 21;118(3):716–31. [PubMed]
7. Phillip Owens A, Mackman N. The Antithrombotic Effects of Statins. Annu Rev Med. 2014 Jan 14;65(1):433–45. [PubMed]
8. Soler-Espejo E, Chen Y, Rivera-Caravaca JM, Ramos-Bratos MP, Esteve-Pastor MA, Marín F, et al. Relation of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio to residual risk in anticoagulated patients with atrial fibrillation: a report from the prospective Murcia AF Project III cohort. Cardiovasc Diabetol. 2025 Sep 30;24(1):374. [PubMed]
9. Ip B, Yip T, Hung T, Yam TF, Yeung C, Ko H, et al. Lipid control and stroke risk in atrial fibrillation patients treated with direct oral anticoagulants and statins. Eur Stroke J. 2025 Mar;10(1):137–44. [PubMed]
10. Omelchenko A, Hornik-Lurie T, Gabay H, Minha S, Assali A, Pereg D. LDL Cholesterol and Ischemic Stroke in Patients with Nonvalvular Atrial Fibrillation. Am J Med. 2021 Apr;134(4):507–13. [PubMed]
11. Lane DA, Lip GYH. Use of the CHA2 DS2 -VASc and HAS-BLED Scores to Aid Decision Making for Thromboprophylaxis in Nonvalvular Atrial Fibrillation. Circulation. 2012 Aug 14;126(7):860–5. [PubMed]
12. Yuan S, Tang B, Zheng J, Larsson SC. Circulating Lipoprotein Lipids, Apolipoproteins and Ischemic Stroke. Ann Neurol. 2020 Dec;88(6):1229–36. [PubMed]
13. Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993 Jan;24(1):35–41. [PubMed]
14. Castellano JM, Chinitz J, Willner J, Fuster V. Mechanisms of Stroke in Atrial Fibrillation. Card Electrophysiol Clin. 2014 Mar;6(1):5–15. [PubMed]
15. Undas A, Brummel-Ziedins KE, Mann KG. Anticoagulant effects of statins and their clinical implications. Thromb Haemost. 2014;112(03):392–400. [PubMed]
16. Tousoulis D, Psarros C, Demosthenous M, Patel R, Antoniades C, Stefanadis C. Innate and Adaptive Inflammation as a Therapeutic Target in Vascular Disease. J Am Coll Cardiol. 2014 Jun;63(23):2491–502. [PubMed]
17. Huang T, Yap L, Chen C, Lin H, Lin S, Li Y. Long Term Statin Use Is Associated With Reduced Rates of Adverse Events in Patients With Newly Diagnosed Atrial Fibrillation. J Am Heart Assoc. 2024 Dec 17;13(24):e035827. [PubMed]
18. Ding WY. Residual Stroke Risk in Atrial Fibrillation. Arrhythmia Electrophysiol Rev. 2021 Oct 27;10(3):147–53. [PubMed]
19. Ntaios G, Papavasileiou V, Diener HC, Makaritsis K, Michel P. Nonvitamin-K-Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Previous Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Stroke. 2012 Dec;43(12):3298–304. [PubMed]
20. Hu YF, Chen YJ, Lin YJ, Chen SA. Inflammation and the pathogenesis of atrial fibrillation. Nat Rev Cardiol. 2015 Apr;12(4):230–43. [PubMed]
Received: 06 October 2025
Published online: 02 April 2026