Post-Stroke Statins Reduce the Risk of Recurrent Stroke and Death

Another study, published in the latest issue of Neurology, supports the use of statin therapy* after a first-time ischemic stroke to reduce the risk of recurrent stroke. Moreover, data support the use of post-stroke statin therapy to reduce the risk of long-term mortality.

In a retrospective, observational study of the Athenian Stroke Registry (N = 794), the risk of a second stroke was reduced by 46% (absolute risk reduction, 16.3% - 7.6% = 8.8%; P = .002) with statin therapy during a 10-year period.** The risk of death during follow-up was also significantly reduced with the use of post-stroke statins: 11 deaths among statin-treated patients vs 213 among non-statin-treated patients. These data remained consistent after adjustments were made for blood-pressure control and 12-month lipid levels—suggesting that statin-related neuroprotection is achieved independently of lipid control. (Other independent predictors of mortality after a first-time stroke included a history of coronary and peripheral artery disease, atrial fibrillation, heart failure, and stroke severity.)

In most cases, statin therapy was continued after the first stroke; although some patients initiated statin therapy after their first stroke. Medication adherence rates were estimated at about 70%. Subanalyses of data on the basis of statin type or dosage were not performed owing to their limited statistical power.

Approximately 30% of the 700,000 strokes that occur each year in Americans are recurrent strokes.

* Simvastatin 10-40 mg/d (34%); atorvastatin 10-40 mg/d (26%); pravastatin 20-40 mg/d (22%); or fluvastatin 40-80 mg/d (18%).

** There was no significant difference in the time of second stroke in the 2 treatment groups: 21 vs 19 months.

CT brain image showing massive right hemispheric infarct with midline shift; from Wikipedia.