Statins after recent stroke reduces recurrence and improves survival in an aging Mediterranean population without known coronary heart disease
Journal of Clinical Pharmacy and Therapeutics, 05/03/2012
Sicras–Mainar A et al. – Statin therapy in patients with first–ever acute stroke lowers the risk of 6–year stroke recurrence and improves survival in an aging Mediterranean cohort. These results add additional evidence in routine clinical practice to the observed effects of statins in clinical trials.Methods
- A retrospective study was carried out using records on death, hospitalizations owing to stroke and history of statin therapy included in the Badalona Serveis Assistencials (BSA) database.
- The cohort studied consisted of consecutive patients covered by the BSA health provider plan with a first–ever acute stroke episode during January 2003 until December 2008, for whom there was available information covering the 6–year follow–up period.
- Recurrence rate (RR) and incidence rate (IR) of fatal/non–fatal stroke and all–causes mortality were computed.
- Association with statin therapy was assessed by means of calculation of relative risk (RR) and hazard ratio (HR) using multivariate logistic regression and Cox proportional hazards models controlling for confounding covariates.
- The cohort comprised a series of 601 consecutive patients [57% men, 75•9 (12•4) years old (88% >60 years)].
- Of these, 32% received statins, which were associated with lower fatal/non–fatal recurrent stroke RR; 7% vs. 18% [adjusted RR = 0•32 (CI: 0•16–0•61), P = 0•001] and lower IR; 16•78 vs. 45•22 events/year–1000 subjects [adjusted HR = 0•35 (0•19–0•64), P = 0•001].
- Similarly, observed all–causes mortality was lower in the cohort receiving statins; 11% vs. 16% [adjusted RR = 0•29 (CI: 0•08–1•12), P = 0•072], and also mortality rate; 26•09 vs. 36•25 deaths/year–1000 subjects [adjusted HR = 0•23 (0•08–0•67), P = 0•007].