on August 30, 2007
Published online before print August 30, 2007, doi: 10.1161/STROKEAHA.107.487017
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on March 4, 2007
From the Cardiovascular Department (F.C., M.S.), San Filippo Neri Hospital; IRCCS Santa Lucia Foundation (A.B., C.C.); and the Department of Neurology (C.C.), University of Rome "Tor Vergata," Rome, Italy. * To whom correspondence should be addressed. E-mail: furcol{at}rdn.it.
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.
Accepted on April 11, 2007
Discontinuation of Statin Therapy and Clinical Outcome After Ischemic Stroke
Furio Colivicchi MD, FESC*;
Key words: adherence • statins • stroke
Related Article:
Stroke 2007 38: 2629-2630.
This article has been cited by other articles:
 |
|
 |
|
  H. J. Milionis, S. Giannopoulos, M. Kosmidou, V. Panoulas, E. Manios, A. P. Kyritsis, M. S. Elisaf, and K. Vemmos Statin therapy after first stroke reduces 10-year stroke recurrence and improves survival Neurology, May 26, 2009; 72(21): 1816 - 1822. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. D. Auerbach Changing the Practice of Perioperative Cardioprotection: Perioperative {beta}-Blockers After POISE (PeriOperative ISchemic Evaluation) Circ Cardiovasc Qual Outcomes, September 1, 2008; 1(1): 58 - 61. [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Daskalopoulou, J. A.C. Delaney, K. B. Filion, J. M. Brophy, N. E. Mayo, and S. Suissa Discontinuation of statin therapy following an acute myocardial infarction: a population-based study Eur. Heart J., September 1, 2008; 29(17): 2083 - 2091. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Ritz and C. Wanner Lipid Abnormalities and Cardiovascular Risk in Renal Disease J. Am. Soc. Nephrol., June 1, 2008; 19(6): 1065 - 1070. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Gueyffier and T. Bejan-Angoulvant Do We Need to Assess the Effect of Treatment Withdrawal?: The Paradigm of Life-Long Prevention Stroke, October 1, 2007; 38(10): 2629 - 2630. [Full Text] [PDF]
|
|