Discontinuation of Statin Therapy and Clinical Outcome After Ischemic Stroke
Abstract
Background and Purpose— The majority of patients with previous ischemic stroke are expected to benefit significantly from long-term statin therapy. However, discontinuation of medication therapy frequently occurs in clinical practice. The aim of this study was to assess the impact of discontinued statin therapy on clinical outcome in patients discharged after an acute ischemic stroke. Methods— The study population included 631 consecutive stroke survivors (322 men and 309 women; mean±SD age, 70.2±7.6 years) without clinical evidence of coronary heart disease. All patients were discharged on statin therapy and were followed up for 12 months after the acute ischemic stroke. Results— Within 12 months from discharge, 246 patients (38.9%) discontinued statin therapy; the mean time from discharge to statin discontinuation was 48.6±54.9 days (median time, 30 days; interquartile range, 18 to 55 days). During follow-up, 116 patients died (1-year probability of death=0.18; 95% CI, 0.15 to 0.21). Multivariate analysis demonstrated that after adjustment for all confounders and interactions, statin therapy discontinuation (hazard ratio=2.78; 95% CI, 1.96 to 3.72; P =0.003) was an independent predictor of all-cause 1-year mortality. Conclusions— A large number of patients discontinue their use of statins early after acute stroke. Moreover, patients discontinuing statins have a significantly increased mortality during the first year after the acute cerebrovascular event. These findings suggest that patient care should be improved during the transition from a hospital setting to outpatient primary care.
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Cohort studies involving approximately 14,000 subjects reported that ischemic stroke incidence increases in both men and women when postprandial hypertriglyceridemia is present.
“Furthermore, the results of cohort studies involving approximately 14,000 subjects reported that ischemic stroke incidence increases in both men and women when postprandial hypertriglyceridemia is present864).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [864]
A 1-mmol/L (88.5 mg/dL) increase in the postprandial TG level increases ischemic stroke risk by 15%.
“These results indicate that a 1-mmol/L (88.5 mg/dL) increase in the postprandial TG level increases ischemic stroke risk by 15%.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [864]
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- Authors
- Colivicchi, F., Bassi, A., Santini, M., & Caltagirone, C.
- Affiliations
- University of Rome Tor Vergata (IT)
- Venue
- Stroke
- Published
- 2007-10
- Volume
- 38
- Issue
- 10
- Pages
- 2652-2657
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2122857025
- Cited by
- 174
- References
- 32
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 7 · 2021: 5 · 2020: 10 · 2019: 10 · 2018: 6 · 2017: 9 · 2016: 17 · 2015: 7 · 2014: 11 · 2013: 11 · 2012: 8
- FWCI
- 14.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- statin therapy, drug discontinuation, ischemic stroke, stroke survivors, all-cause mortality, secondary stroke prevention, primary care
- MeSH terms
- Atorvastatin, Aged, Brain Ischemia, Female, Follow-Up Studies, Heptanoic Acids, Humans, Male, Middle Aged, Predictive Value of Tests, Pyrroles, Substance Withdrawal Syndrome, Multivariate Analysis, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Simvastatin, Stroke, Kaplan-Meier Estimate
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