Hackam DG et al. – Statin exposure following ischemic stroke was not associated with intracerebral hemorrhage (ICH).
Retrospective propensity–matched cohort study with accrual from July 1, 1994, to March 31, 2008.
A total of 17 872 patients aged 66 years and older who initiated statin therapy following acute ischemic stroke and were followed for a median of 4.2 years (interquartile range, 2.4–5.0 years).
To enhance causal inference, the conducted several tests of specificity to exclude healthy user bias in this sample.
Hospitalization or emergency department visit for ICH defined using validated diagnosis coding.
Overall, 213 episodes of ICH occurred.
In the primary analysis comparing statin users with nonusers, the authors found no association between statins and ICH (hazard ratio = 0.87; 95% confidence interval, 0.65–1.17).
Subgroup and dose–response analyses yielded similar results.
In tests of specificity, statin therapy was not associated with bone mineral density testing, vitamin D or B12 screening, gastrointestinal endoscopy, or elective knee arthroplasty, suggesting that results were not due to healthy user bias or differences in quality of care.
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