Adjunctive Statin Therapy Reduces Mortality After Acute Hemorrhagic Stroke

Overview

Journal Risk Manag Healthc Policy

Publisher Dove Medical Press

Specialty Public Health

Date 2021 Jan 25

PMID 33488130

Citations 2

Authors

Cheng-Kai Lin

Po-Yuan Chen

Yu-Ying Wu

Cheng-Chun Wu

Han-Jung Chen

Cheng-Loong Liang

Yi-Che Lee

Chi-Wei Lin

Chao-Ming Hung

Hao-Kuang Wang

Affiliations

Soon will be listed here.

Abstract

Background: Statin treatment improves clinical outcomes in patients with ischemic strokes, although there is no evidence regarding the safety of statin therapy in patients with intracerebral hemorrhage (ICH). This study aimed at evaluating the effects of continuing statin treatment after ICH.

Methods: Data were obtained from the National Health Insurance Research Database in Taiwan. We retrospectively compared the data of patients with and without statin exposure after ICH. The outcomes of interest were recurrence of hemorrhagic stroke and mortality during a follow-up period of 10 years.

Results: During the 10-year follow-up period, the mortality rate was 32.73% in the statin group and 42.77% in the non-statin group. Statin therapy in patients with acute ICH with dyslipidemia can decrease mortality.

Conclusion: Statin therapy reduced the risk of 10-year mortality in patients who experienced acute hemorrhagic stroke.

Citing Articles

Low-Density Lipoprotein Cholesterol and Mortality in Patients With Intracerebral Hemorrhage in Taiwan.

Wen C, Lee Y, Sun Y, Huang C, Tsai C, Chen P Front Neurol. 2022; 12:793471.

PMID: 35113980 PMC: 8802633. DOI: 10.3389/fneur.2021.793471.

Acupuncture May Decrease the Incidence of Post-stroke Dementia: A Taiwan Nationwide Retrospective Cohort Study.

Chu S, Chen T, Chen P, Tzeng W, Liang C, Lu K Front Neurol. 2021; 12:657048.

PMID: 34093405 PMC: 8176024. DOI: 10.3389/fneur.2021.657048.

References

Ribe A, Vestergaard C, Vestergaard M, Fenger-Gron M, Pedersen H, Lietzen L . Statins and Risk of Intracerebral Haemorrhage in a Stroke-Free Population: A Nationwide Danish Propensity Score Matched Cohort Study. EClinicalMedicine. 2019; 8:78-84. PMC: 6537517. DOI: 10.1016/j.eclinm.2019.02.007. View

Navarese E, Robinson J, Kowalewski M, Kolodziejczak M, Andreotti F, Bliden K . Association Between Baseline LDL-C Level and Total and Cardiovascular Mortality After LDL-C Lowering: A Systematic Review and Meta-analysis. JAMA. 2018; 319(15):1566-1579. PMC: 5933331. DOI: 10.1001/jama.2018.2525. View

Tramacere I, Boncoraglio G, Banzi R, Del Giovane C, Kwag K, Squizzato A . Comparison of statins for secondary prevention in patients with ischemic stroke or transient ischemic attack: a systematic review and network meta-analysis. BMC Med. 2019; 17(1):67. PMC: 6436237. DOI: 10.1186/s12916-019-1298-5. View

Chung C, Lin M, Liu C, Lee T, Chang S, Yang T . Discontinuing or continuing statin following intracerebral hemorrhage from the view of a national cohort study. Atherosclerosis. 2018; 278:15-22. DOI: 10.1016/j.atherosclerosis.2018.08.049. View

Jukema J, Zijlstra L, Bhatt D, Bittner V, Diaz R, Drexel H . Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES. Circulation. 2019; 140(25):2054-2062. PMC: 6919220. DOI: 10.1161/CIRCULATIONAHA.119.043826. View

Lei C, Wu B, Liu M, Chen Y . Association between statin use and intracerebral hemorrhage: a systematic review and meta-analysis. Eur J Neurol. 2013; 21(2):192-8. DOI: 10.1111/ene.12273. View

Kusznir Vitturi B, Gagliardi R . The influence of statin withdrawal and adherence on stroke outcomes. Neurol Sci. 2020; 42(6):2317-2323. DOI: 10.1007/s10072-020-04790-y. View

Feng M, Lin Y, Chang Y, Chen C, Chiang H, Huang L . The Mortality and the Risk of Aspiration Pneumonia Related with Dysphagia in Stroke Patients. J Stroke Cerebrovasc Dis. 2019; 28(5):1381-1387. DOI: 10.1016/j.jstrokecerebrovasdis.2019.02.011. View

Lin M, Lin Y, Chang S, Wang P, Wu V, Lin W . Effect of initiating statin therapy on long-term outcomes of patients with dyslipidemia after intracerebral hemorrhage. Atherosclerosis. 2019; 288:137-145. DOI: 10.1016/j.atherosclerosis.2019.07.009. View

10.

Lee M, Saver J, Wu Y, Tang S, Lee J, Rao N . Utilization of Statins Beyond the Initial Period After Stroke and 1-Year Risk of Recurrent Stroke. J Am Heart Assoc. 2017; 6(8). PMC: 5586426. DOI: 10.1161/JAHA.117.005658. View

11.

Scheitz J, MacIsaac R, Abdul-Rahim A, Siegerink B, Bath P, Endres M . Statins and risk of poststroke hemorrhagic complications. Neurology. 2016; 86(17):1590-6. PMC: 4844236. DOI: 10.1212/WNL.0000000000002606. View

12.

Ravnskov U, Diamond D, Hama R, Hamazaki T, Hammarskjold B, Hynes N . Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review. BMJ Open. 2016; 6(6):e010401. PMC: 4908872. DOI: 10.1136/bmjopen-2015-010401. View

13.

Lin H, Tsai W, Lin J, Chang W, Huang C, Wang H . Adjunctive statin therapy reduces intracranial hemorrhage and 1-year mortality in patients with atrial fibrillation after acute ischemic stroke: A population-based epidemiological study from Taiwan. J Clin Neurosci. 2019; 69:224-229. DOI: 10.1016/j.jocn.2019.07.045. View

14.

Ziff O, Banerjee G, Ambler G, Werring D . Statins and the risk of intracerebral haemorrhage in patients with stroke: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2018; 90(1):75-83. DOI: 10.1136/jnnp-2018-318483. View

15.

Chang J, Katsanos A, Khorchid Y, Dillard K, Kerro A, Burgess L . Higher low-density lipoprotein cholesterol levels are associated with decreased mortality in patients with intracerebral hemorrhage. Atherosclerosis. 2017; 269:14-20. DOI: 10.1016/j.atherosclerosis.2017.12.008. View

16.

Hemphill 3rd J, Greenberg S, Anderson C, Becker K, Bendok B, Cushman M . Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015; 46(7):2032-60. DOI: 10.1161/STR.0000000000000069. View

17.

McKinney J, Kostis W . Statin therapy and the risk of intracerebral hemorrhage: a meta-analysis of 31 randomized controlled trials. Stroke. 2012; 43(8):2149-56. DOI: 10.1161/STROKEAHA.112.655894. View

18.

Ma C, Gurol M, Huang Z, Lichtenstein A, Wang X, Wang Y . Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage: A prospective study. Neurology. 2019; 93(5):e445-e457. PMC: 6693427. DOI: 10.1212/WNL.0000000000007853. View

19.

Ribe A, Vestergaard C, Vestergaard M, Pedersen H, Prior A, Lietzen L . Statins and Risk of Intracerebral Hemorrhage in Individuals With a History of Stroke. Stroke. 2020; 51(4):1111-1119. DOI: 10.1161/STROKEAHA.119.027301. View

20.

Ruiz-Leon A, Lapuente M, Estruch R, Casas R . Clinical Advances in Immunonutrition and Atherosclerosis: A Review. Front Immunol. 2019; 10:837. PMC: 6491827. DOI: 10.3389/fimmu.2019.00837. View