Patients with acute ischemic stroke who adhere to a high-intensity statin therapy regimen experience significantly fewer adverse events compared with patients who have poor adherence to medication, according to a retrospective study published in the journal Stroke.
Researchers retrospectively reviewed South Korean health insurance claims data on patients who were hospitalized for an acute ischemic stroke (n=8001) and prescribed statin therapy. The primary outcome of this study was comprised of a composite of myocardial infarction, all-cause mortality, and recurrent stroke.
A component of the primary outcome developed in a total of 2284 patients during the mean follow-up of 4.69±2.72 years. The primary outcome adjusted hazard ratios for good adherence, intermediate adherence, and poor adherence to statin therapy were 0.74 (0.64–0.84; P =.241), 0.93 (0.79–1.09; P =.383), and 1.07 (0.95–1.20; P <.001), respectively.
Among patients with good adherence to a high-intensity statin, the risk for adverse events was noticeably lower compared with patients on a low-intensity statin treatment (adjusted hazard ratio 0.48; 95% CI, 0.24-0.96). Additionally, patients with good adherence on a high-intensity statin did not have an increased risk for hemorrhagic stroke.
Limitations of this study include its retrospective design as well as the study database’s lack of information on potential confounders, including radiologic results, severity of the initial stroke, as well as the stroke’s etiologic mechanism.
The investigators of this study believe further “interventions and encouragements for the use and continuation of high-intensity statin [therapy] in acute ischemic stroke” are necessary to lower the risk for long-term adverse events in this patient population.
Kim J, Lee HS, Nam CM, Heo JH. Effects of statin intensity and adherence on the long-term prognosis after acute ischemic stroke. Stroke. 2017;48:2723-2730.