New Study Highlights Importance of Statin Continuation in Stroke Survivors

Medication is important for all disease states and has been linked to optimal health outcomes. Patients who discontinue their drug regimen for any number of reasons may be putting their health at risk.

For stroke patients, discontinuation of statin therapy between 3 and 6 months after their first ischemic stroke was linked to a heightened risk of recurrent stroke, according to a new study published by the Journal of the American Heart Association.

The authors also discovered that discontinuing statins during this time period was associated with a higher risk of mortality and hospitalization.

Ischemic strokes are the most common form of stroke and occurs as a result of a buildup of cholesterol in the arteries, which blocks blood flow to the brain. Statins work to reduce LDL cholesterol and prevent recurrent events.

Included in the study were 45,151 patients who have experienced an ischemic stroke between 2001 and 2012. All patients were prescribed high or moderate intensity statins within 90 days of hospital discharge. Data were gathered by the Taiwan National Health Insurance Program.

During this time, the authors found that 7% of patients were on reduced statin therapy and 18.5% were not on the drugs, according to the study. Patients who discontinued statins were observed to have a 42% increase in the risk of recurrent stroke.

Importantly, the authors found that there was no increased risk of recurrent stroke or death for patients who took statins at a reduced dose, suggesting that even a small dose is effective.

“Based on our findings of this large group of patients in the ‘real world,’ we believe that statins should be a lifelong therapy for ischemic stroke patients if a statin is needed to lower the patient’s cholesterol,” said lead study author Meng Lee, MD.

Since the study was retrospective, the authors were unable to determine why patients stopped treatment. The authors hypothesize that the Taiwan National Health Bureau’s recommendation to stop or reduce statins among patients once LDL levels are less than 100-mg/dl or total cholesterol of less than 160-mg/dl played a role in cessation, according to the study.

The authors do not believe that drug costs were a factor in discontinuation since the national health insurance covers all treatments, according to the study.

While the study participants were from Taiwan, the authors believe that the findings are also applicable to patients from other countries, as appropriate statin therapy is important for all stroke patients.

“Discontinuation of statin treatment in patients with ischemic stroke should be strongly discouraged in any stage, acute or chronic, of stroke,” Dr Lee said. “Shifting to low-intensity statin therapy could be an alternative for stroke patients not able to tolerate moderate or high intensity statin therapy in the years following a stroke.”