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.'

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