Early in-hospital exposure to statins and outcome after intracerebral haemorrhage – results from the Virtual International Stroke Trials Archive

Doerrfuss, J. I., Abdul-Rahim, A. H. , Siegerink, B., Nolte, C. H., Lees, K. R., Endres, M., Kasner, S. E. and Scheitz, J. F. (2020) Early in-hospital exposure to statins and outcome after intracerebral haemorrhage – results from the Virtual International Stroke Trials Archive. European Stroke Journal, 5(1), pp. 85-93. (doi: 10.1177/2396987319889258) (PMID:32232174) (PMCID:PMC7092741)

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Abstract

Introduction: Recent data suggest that statin use after intracerebral haemorrhage might be beneficial. However, data on the effects of early in-hospital statin exposure are lacking. Therefore, we sought to assess whether (1) early statin exposure during the acute phase after intracerebral haemorrhage and (2) early continuation of prevalent statin use are associated with favourable functional outcome. Patients and methods: Data were obtained from the Virtual International Stroke Trials Archive. Patients were categorised according to use patterns of statins during this early in-hospital phase (continuation, discontinuation or new initiation of statins). Univariate and multivariable analyses were conducted to explore the association between early statin exposure and functional outcome. Results: A total of 919 patients were included in the analysis. Early in-hospital statin exposure (n = 89, 9.7%) was associated with better functional outcome (modified Rankin Scale ≤ 3) compared with 790 patients without statin exposure before or early after the event (66% versus 47%, adjusted OR 2.1, 95% confidence interval 1.3–3.6).  Compared with patients without exposure to statins before and early after the event, early continuation of statin therapy (n = 57) was associated with favourable functional outcome (adjusted odds ratio 2.6, 95% confidence interval 1.3–5.2). The association between early continuation of statins and outcome remained robust in sensitivity analyses restricted to patients able to take oral medication within 72 h and one-week survivors. Discussion: It is possible that part of the observed associations are not due to a protective effect of statins but are confounded by indication bias. Conclusion: Statin exposure and continuation of prevalent statin therapy early after intracerebral haemorrhage are associated with favourable functional outcome after 90 days.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Abdul-Rahim, Dr Azmil and Lees, Professor Kennedy and Scheitz, Dr Jan-Friedrich
Authors: Doerrfuss, J. I., Abdul-Rahim, A. H., Siegerink, B., Nolte, C. H., Lees, K. R., Endres, M., Kasner, S. E., and Scheitz, J. F.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:European Stroke Journal
Publisher:SAGE Publications
ISSN:2396-9873
ISSN (Online):2396-9881
Published Online:25 November 2019
Copyright Holders:Copyright © 2019 European Stroke Organisation
First Published:First published in European Stroke Journal 5(1): 85-93
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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