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Statins as secondary preventives in patients with intracerebral hemorrhage
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Epidemiology.ORCID iD: 0000-0001-8693-1014
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Orebro Univ, Univ Hlth Care Res Ctr, Fac Med & Hlth, SE-70185 Rebro, Sweden.
2020 (English)In: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 15, no 1, p. 61-68Article in journal (Refereed) Published
Abstract [en]

Background: Statins are important components of secondary stroke prevention, but there is a concern they may increase the risk of intracerebral hemorrhage. Although this risk may have been overestimated, there is still an open question whether statin therapy should be continued, or even initiated, in patients who have had a recent intracerebral hemorrhage.

Aim: Our aim was to investigate the risk of statin use after an intracerebral hemorrhage with respect to recurrent intracerebral hemorrhage, stroke in general, and death.

Methods: This observational study was based on patients with a first intracerebral hemorrhage in 2004 through 2009. Clinical characteristics, index intracerebral hemorrhage, and recurrent intracerebral hemorrhages were identified by the Swedish Stroke Register; additional data on comorbidities and vital status were retrieved through record linkages to national registers. A propensity score for the likelihood of receiving statins at discharge was developed and used with other established risk factors in a multivariable analysis.

Results: Of 6082 intracerebral hemorrhage patients (mean age 69.6 years), 1097 (18%) were prescribed statins at discharge. During the follow-up (mean 3.1 years), 1434 (23.6%) deaths and 234 (3.8%) recurrent intracerebral hemorrhages were observed. Statin therapy was associated with a reduced risk of death (adjusted hazard ratio: 0.71; 95% confidence interval: 0.60-0.84) but not with the risk of recurrent intracerebral hemorrhage (adjusted hazard ratio: 0.82; 95% confidence interval: 0.55-1.22).

Conclusions: This study provides some reassurance that statins may be safe to use, in at least some patients, after an intracerebral hemorrhage. In patients with intracerebral hemorrhage, statin use was associated with a reduced risk of death, without an increased risk of recurrent intracerebral hemorrhage.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2020. Vol. 15, no 1, p. 61-68
Keywords [en]
Epidemiology, intracerebral hemorrhage, statins, prevention
National Category
Neurology Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-407137DOI: 10.1177/1747493018816476ISI: 000511002800010PubMedID: 30484749OAI: oai:DiVA.org:uu-407137DiVA, id: diva2:1415869
Available from: 2020-03-20 Created: 2020-03-20 Last updated: 2020-03-20Bibliographically approved

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Åsberg, SignildHenriksson, Karin M.

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