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Atherosclerosis. 2018 Nov;278:15-22. doi: 10.1016/j.atherosclerosis.2018.08.049. Epub 2018 Aug 31.

Discontinuing or continuing statin following intracerebral hemorrhage from the view of a national cohort study.

Author information

1
School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
2
Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
3
Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taiwan.
4
Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan. Electronic address: dissertlin@gmail.com.

Abstract

BACKGROUND AND AIMS:

Statins improve clinical outcomes in patients with ischemic stroke but there is no evidence of the effect of continuing long-term statin therapy in patients with intracerebral hemorrhage (ICH). The aim of this study was to evaluate the impact of continuing statin after ICH.

METHODS:

Data on patients with ICH was retrieved from the National Health Insurance Research Database of Taiwan. The final population was separated into two groups according to those who continued and those who discontinued statin treatment. All-cause mortality and cardiovascular outcomes were analyzed after a 3 year follow-up after propensity score matching (PSM).

RESULTS:

Of the 114,101 patients with ICH, who were initially enrolled, 2468 patients with dyslipidemia and ICH were included. After PSM, the benefit of statin therapy on mortality appeared from 1 year to the end of the 3-year follow-up period after discharge (statin group versus non-statin group: 4.9% vs.12.3% at 1 year (hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.26-0.57) and 12.9% vs. 25.3% at the end of the 3 year follow-up period (HR, 0.45; 95% CI, 0.35-0.58). Compared with the patients using lipophilic statins, those using hydrophilic statins had a significantly lower incidence of all-cause mortality (HR = 0.65, 95% CI = 0.43-0.99). There were no differences between those prescribed moderate-intensity statins and those prescribed high-intensity statins in terms of stroke and all-cause mortality (HR = 0.76; 95% CI = 0.40-1.46).

CONCLUSIONS:

There was a lower risk of all-cause mortality following ICH in patients who continued statin treatment compared with those without statin treatment, especially in those treated with hydrophilic statins.

KEYWORDS:

Cerebrovascular; Intracerebral hemorrhage; Mortality; Statin

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