Stopping statins after stroke linked to higher risk of recurrent stroke

Patients who stop statin therapy 3 to 6 months after an ischaemic stroke run a much higher risk of having a second stroke than patients who continue therapy, according to a study recently published in the Journal of the American Heart Association.

Statins are among the most effective drugs in reducing the risk of stroke, particularly ischaemic stroke. | SCIENCE PHOTO LIBRARY
Statins are among the most effective drugs in reducing the risk of stroke, particularly ischaemic stroke. | SCIENCE PHOTO LIBRARY

Researchers at the Chang Gung University College of Medicine in Taiwan used data from the Taiwan National Health Insurance Research Database to identify all patients who were prescribed high- or moderate-intensity statin therapy within 90 days of discharge following an ischaemic stroke between 2001 and 2012 (n=45,151).

The study period spanned the 3 to 6 months following discharge, during which time 7% of patients were on reduced doses of statins, 18.5% were no longer receiving statins and the remainder continued to take moderate- or high-intensity statins.

The primary endpoint was the first occurrence of any recurrent stroke in the 6 to 18 months following the original stroke.

Compared with maintenance of statin therapy, discontinuation of statins was associated with a 42% greater risk of recurrent ischaemic or haemorrhagic stroke (adjusted hazard ratio 1.42, 95% CI 1.28–1.57, p<0.0001). There was no additional risk of a second event for patients on reduced doses of statins. 

In addition, patients who discontinued statin therapy had a 37% greater risk of all-cause mortality (adjusted hazard ratio 1.37, 95% CI 1.11–1.70, p=0.003).

Strong recommendations

'Discontinuation of statin treatment in patients with ischemic stroke should be strongly discouraged in any stage, acute or chronic, of stroke,' said the study lead author Dr Meng Lee.

'Shifting to low-intensity statin therapy could be an alternative for stroke patients not able to tolerate moderate- or high-intensity statin therapy in the years following a stroke.'

Want news like this straight to your inbox?
Sign up for our bulletins

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register
Already registered?
Sign in

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases