Statin Use May Improve Poststroke Mortality

Article excerpt

Patients who discontinue their use of statins within the first year after a stroke may have a significantly increased risk of death, even in the absence of diagnosed heart disease, according to findings from a single-center observational study.

"This is the first evidence linking discontinuation of statins to increased mortality in stroke survivors without any clinical evidence of CHD," reported Dr. Furio Colivicchi of the San Filippo Neri Hospital, Rome, and his colleagues.

"The findings suggest that patient care should be improved during the transition from a hospital setting to outpatient primary care."

From a consecutive series of 3,974 patients with acute stroke who were discharged from a hospital during a 4.5-year period, the researchers selected 631 patients who had no major concurrent illness, no evidence of coronary artery disease or other major cardiac conditions, and who were discharged on either atorvastatin (Lipitor) or simvastatin (Zocor) to determine what effect statin discontinuation had on mortality during the first year after stroke.

The 631 patients in the study had an average age of 70 years (Stroke 2007 [Epub doi:10.1161/strokeaha.107.487017]).

In multivariate analysis, discontinuation of statins was an independent predictor of all-cause mortality at 1 year; patients who discontinued statins had nearly a threefold higher risk of death than those who continued to take their prescription. The risk of death was highest soon after discontinuing statins and gradually decreased with time.

Of 246 patients who discontinued statin therapy during the 1-year follow-up period, 175 (71%) had no specific medical reason for discontinuation. Mild side effects, such as dyspepsia, fatigue, headache, myalgias, and an asymptomatic rise in plasma levels of liver enzymes, were the reason for discontinuation in the remaining 71 (29%) patients. …