Patients hospitalised with ischaemic stroke should be immediately treated with a statin, conclude the authors of a large study showing it substantially improves long-term survival.
Reporting in Stroke, the US researchers found giving statins early in stroke hospitalisation greatly improved survival following a stroke, while withdrawing statins in hospital – even only briefly –lowered survival.
Following over 12,000 ischaemic stroke patients, they found statin use before and during hospitalisation was associated with a 41% lower chance of dying within a year.
But those patients who used statins before hospitalisation, and were taken off them in hospital, were more than twice as likely to die during the 12 month follow-up compared with those who continued to take statins (hazard ratio = 2.5, CI = 2.1-2.9).
Strikingly, those who were withdrawn from a statin had worse outcomes than those who did not take one at all – with an 85% increased risk of death during follow-up, even after controlling for confounders.
Looking for data suggestive of a causal relationship, the researchers found a dose-response effect, with those taking more than 60mg of statin per day experiencing an even greater risk reduction of 57%.
Additionally, the earlier patients were treated with statins, the better their chance of survival, both among patients previously treated with statins and those who never took them.
The relationship between statin use and improved poststroke survival could not be explained by cofounding at the individual patient level, nor by stroke severity, the authors said.
“It seems clinically prudent to treat patients with ischemic stroke with a statin from the beginning of stroke hospitalisation,” they concluded.
The authors did not declare any conflicts of interest.