Highlights
- •We investigated whether statin treatment in patients with AF-related stroke is associated with improved survival and reduced risk for stroke recurrence and future cardiovascular events.
- •Among 1602 stroke patients, statin treatment was independently associated with a lower mortality (hazard-ratio (HR): 0.49, 95%CI: 0.26-0.92) and lower risk for the composite cardiovascular endpoint during the median 22 months follow-up (HR: 0.44, 95%CI:0.22-0.88), but not with stroke recurrence (HR: 0.47, 95%CI:0.22-1.01, p:0.053).
- •Statin treatment was associated with improved survival and reduced risk for future cardiovascular events in AF-related stroke.
Abstract
Background/objectives
The most recent ACC/AHA guidelines recommend high-intensity statin therapy in ischemic
stroke patients of presumably atherosclerotic origin. On the contrary, there is no
specific recommendation for the use of statin in patients with non-atherosclerotic
stroke, e.g. strokes related to atrial fibrillation (AF). We investigated whether
statin treatment in patients with AF-related stroke is associated with improved survival
and reduced risk for stroke recurrence and future cardiovascular events.
Methods
All consecutive patients registered in the Athens Stroke Registry with AF-related
stroke and no history of coronary artery disease nor clinically manifest peripheral
artery disease were included in the analysis and categorized in two groups depending
on whether statin was prescribed at discharge. The primary outcome was overall mortality;
the secondary outcomes were stroke recurrence and a composite cardiovascular endpoint
comprising of recurrent stroke, myocardial infarction, aortic aneurysm rupture or
sudden cardiac death during the 5-year follow-up.
Results
Among 1602 stroke patients, 404 (25.2%) with AF-related stroke were included in the
analysis, of whom 102 (25.2%) were discharged on statin. On multivariate Cox-proportional-hazards
model, statin treatment was independently associated with a lower mortality (hazard-ratio
(HR): 0.49, 95%CI:0.26–0.92) and lower risk for the composite cardiovascular endpoint
during the median 22 months follow-up (HR: 0.44, 95%CI:0.22–0.88), but not with stroke recurrence (HR:
0.47, 95%CI:0.22–1.01, p: 0.053).
Conclusions
In this long-term registry of patients with AF-related stroke, statin treatment was
associated with improved survival and reduced risk for future cardiovascular events.
Keywords
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Article info
Publication history
Published online: September 25, 2014
Accepted:
September 16,
2014
Received:
June 24,
2014
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
