Higher risk of recurrent stroke after early statin discontinuation
Utilization of Statins Beyond the Initial Period After Stroke and 1-Year Risk of Recurrent StrokeLiterature - Lee M, Saver JL, Wu Y-L, et al. - J Am Heart Assoc. 2017;6:e005658
- Among the 45 151 ischemic stroke patients 74.5% were in the statin-maintained group, 7.0% were in the statin-reduced group, and 18.5% were not on any statin therapy.
- In the whole cohort, 2120 recurrent strokes were observed during the 1-year follow-up.
- In multivariable analyses, compared with the statin-maintained group, the discontinuation of statins was associated with an increased hazard of recurrent ischemic or hemorrhagic stroke (6.2% vs. 4.4%; adjHR: 1.42; 95%CI: 1.28-1.57; P<0.0001), whereas the statin-reduced group did not show an additional risk (4.1% vs. 4.4%; adjHR: 0.94; 95%CI: 0.78-1.12; P=0.47).
Compared with the statin-maintained group, the discontinuation of statins was associated with higher risks of:
- ischemic stroke: 5.6% vs. 3.9%; adjusted HR: 1.45; 95%CI: 1.30-1.61; P<0.0001
- all-cause mortality: 1.4% vs. 1.0%; adjusted HR: 1.37; 95%CI: 1.11-1.70; P=0.003
- all major events: 7.8% vs. 5.6%; adjusted HR: 1.38; 95%CI: 1.26-1.51; P<0.0001
- any hospitalization: 31.7% vs. 27.1%; adjusted HR: 1.19; 95%CI: 1.14-1.24; P<0.0001
- Statin discontinuation had a neutral effect on intracerebral hemorrhage and on MI.
- Statin-reduced therapy was not associated with increased risks of ischemic stroke, intracerebral hemorrhage, all-cause mortality, MI, or all major events.
The discontinuation of statin therapy 3 to 6 months after an index ischemic stroke event, was associated with a higher risk of recurrent stroke within 1 year after statin discontinuation. These findings suggest that stroke patients should not discontinue statin therapy, unless there is a serious reason for doing so.