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Neurology. 2016 Apr 26;86(17):1590-6. doi: 10.1212/WNL.0000000000002606. Epub 2016 Mar 25.

Statins and risk of poststroke hemorrhagic complications.

Author information

1
From the Center for Stroke Research Berlin (J.F.S., B.S., M.E., C.H.N.), Klinik für Neurologie (J.F.S., M.E., C.H.N.), Clinical Epidemiology and Health Services Research in Stroke (CEHRiS) (B.S.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charité-Universitätsmedizin Berlin, Germany; Stroke Research (R.L.M., A.H.A.-R., K.R.L.), Institute of Cardiovascular & Medical Sciences, University of Glasgow; and Stroke Trials Unit (P.M.B.), Division of Clinical Neuroscience, University of Nottingham, UK. jan-friedrich.scheitz@charite.de.
2
From the Center for Stroke Research Berlin (J.F.S., B.S., M.E., C.H.N.), Klinik für Neurologie (J.F.S., M.E., C.H.N.), Clinical Epidemiology and Health Services Research in Stroke (CEHRiS) (B.S.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charité-Universitätsmedizin Berlin, Germany; Stroke Research (R.L.M., A.H.A.-R., K.R.L.), Institute of Cardiovascular & Medical Sciences, University of Glasgow; and Stroke Trials Unit (P.M.B.), Division of Clinical Neuroscience, University of Nottingham, UK.

Abstract

OBJECTIVE:

To assess whether statin treatment before or after acute ischemic stroke (AIS) affects the risk of acute intracerebral hemorrhage (ICH), postacute ICH, and mortality within 90 days.

METHODS:

Data were sought from the Virtual International Stroke Trials Archive, an international repository of clinical trials data. Using propensity score matching, we retrospectively compared patients with prior statin treatment and newly initiated statin within 3 days after AIS to patients without statin exposure. Outcomes of interest were acute symptomatic ICH (sICH), any acute ICH, postacute ICH, and mortality during follow-up of 3 months.

RESULTS:

A total of 8,535 patients (mean age 70 years, 54% male, median baseline NIH Stroke Scale score 13) were analyzed. After propensity score matching, prior statin use was not strongly associated with sICH (adjusted odds ratio [OR] 1.33, 95% confidence interval [CI] 0.83-2.14) or any ICH (adjusted OR 1.35, 95% CI 0.92-1.98). There was no evidence of an interaction between prior statin use and thrombolysis. New initiation of statins was not associated with postacute ICH (adjusted hazard ratio [HR] 1.60, 95% CI 0.70-3.65). There was a signal towards lower 90-day mortality in patients with prior statin use (adjusted HR 0.84, 95% CI 0.70-1.00) and especially early initiation of statins (adjusted HR 0.67, 95% CI 0.46-0.97).

CONCLUSIONS:

Statin use prior to AIS was not associated with early hemorrhagic complications, irrespective of treatment with thrombolysis. New initiation of statin treatment early after AIS did not affect risk of postacute ICH, but might be associated with reduced mortality.

PMID:
27016519
PMCID:
PMC4844236
DOI:
10.1212/WNL.0000000000002606
[Indexed for MEDLINE]
Free PMC Article

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