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The benefit of statin therapy in secondary prevention for acute ischemic stroke (IS) is demonstrated. But whether early statin therapy is associated with the development of hemorrhagic stroke in IS patients is still under debate. We assess the effect of in-hospital initiation of statin therapy on hemorrhagic stroke in patients with IS.
We screened the databank of the Bureau of National Health Insurance in Taiwan from January 2006 to December 2008. Patients who were admitted for their new IS and without prior statin therapy within 3 months before admission were included in this study. The patients (n=21,704, mead age 66.1 years, male 56.1%) receiving statin treatment during hospitalization were recognized as early statin use group and the others (n=84,905, mead age 70.4 years, male 60.6%) were defined as control group. The study end point was the occurrence of hemorrhagic stroke during the follow-up period. All eligible patients were followed up until 31 December, 2010 after discharge. Cox proportional hazards analyses and matched propensity score analyses were used to evaluate the effect of early statin therapy on hemorrhagic stroke.
During the follow-up period, 2,827 patients developed hemorrhagic stroke: 511 (2.35%) in early statin use group, and 2,316 (2.73%) in control group. Patients in early statin use group had less incidence of hemorrhagic stroke (hazard ratio: 0.84; 95% confidence interval: 0.77 – 0.93, p < 0.001) when compared with control group. Furthermore, matched propensity score analyses were consistent with the results of Cox proportional hazards analyses (hazard ratio: 0.88; 95% confidence interval: 0.78 – 0.99, p = 0.033).
Our study showed in-hospital initiation of statin therapy didn't increase the risk of hemorrhagic stroke in IS patients, and the result implied safety of statin therapy in secondary prevention fort acute IS.
Moderated Poster Contributions
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Prevention: Opportunities for Improvement
Abstract Category: 24. Prevention: Clinical
Presentation Number: 1274M-9
- 2013 American College of Cardiology Foundation