Ming-Shyan Lin1, Yu-Sheng Lin2, Shih-Tai Chang1, Po-Chang Wang1, Victor Chien-Chia Wu3, Wey-Yil Lin4, Chang-Min Chung5. 1. Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan. 2. Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, Taiwan. 3. Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan. 4. Department of Neurology, Taiwan Landseed Hospital, Taoyuan, Taiwan. 5. Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, Taiwan. Electronic address: cmchung02@gmail.com.
Abstract
BACKGROUND AND AIMS: Intracerebral hemorrhage (ICH) has a higher mortality than ischemic stroke. Statin is beneficial for stroke, but high potency statin treatment has been associated with the risk of hemorrhagic stroke. The aim of this study was to assess the impact of initiating statin therapy after ICH on cardiovascular outcomes. METHODS: Dyslipidemic patients were retrieved from the ICH population from the National Health Insurance Research Database in Taiwan. We retrospectively compared patients prescribed with and without statin treatment after ICH. Outcomes of interest were mortality, myocardial infarction, ischemic stroke, and hemorrhagic stroke during 5 years of follow-up. RESULTS: Of 17,980 adult patients with ICH and dyslipidemia, 8927 were eligible for analysis over the study period, including 1613 patients receiving statin therapy and 7314 patients not taking statins. After propensity score matching, the mean age was 61.2 ± 12.2 years in the statin group and 61.6 ± 13.0 years in the non-statin group. Hypertension was dominant, followed by diabetes mellitus, and the mean estimated NIHSS score was 12.9. The patients who received statin therapy were associated with lower risks of all-cause mortality (12.7% vs. 21.3%; hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.45-0.65), cardiovascular death (4.0% vs. 7.1%; HR, 0.54; 95% CI, 0.39-0.75) and ICH (5.4% vs. 8.5%; HR, 0.62; 95% CI, 0.46-0.83) compared to those who did not receive statins. CONCLUSIONS: Initiating statin therapy after ICH was associated with a decreased risk of recurrent ICH and mortality for dyslipidemia patients.
BACKGROUND AND AIMS: Intracerebral hemorrhage (ICH) has a higher mortality than ischemic stroke. Statin is beneficial for stroke, but high potency statin treatment has been associated with the risk of hemorrhagic stroke. The aim of this study was to assess the impact of initiating statin therapy after ICH on cardiovascular outcomes. METHODS: Dyslipidemic patients were retrieved from the ICH population from the National Health Insurance Research Database in Taiwan. We retrospectively compared patients prescribed with and without statin treatment after ICH. Outcomes of interest were mortality, myocardial infarction, ischemic stroke, and hemorrhagic stroke during 5 years of follow-up. RESULTS: Of 17,980 adult patients with ICH and dyslipidemia, 8927 were eligible for analysis over the study period, including 1613 patients receiving statin therapy and 7314 patients not taking statins. After propensity score matching, the mean age was 61.2 ± 12.2 years in the statin group and 61.6 ± 13.0 years in the non-statin group. Hypertension was dominant, followed by diabetes mellitus, and the mean estimated NIHSS score was 12.9. The patients who received statin therapy were associated with lower risks of all-cause mortality (12.7% vs. 21.3%; hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.45-0.65), cardiovascular death (4.0% vs. 7.1%; HR, 0.54; 95% CI, 0.39-0.75) and ICH (5.4% vs. 8.5%; HR, 0.62; 95% CI, 0.46-0.83) compared to those who did not receive statins. CONCLUSIONS: Initiating statin therapy after ICH was associated with a decreased risk of recurrent ICH and mortality for dyslipidemiapatients.
Authors: Rajeev K Garg; Jawad Khan; Robert J Dawe; James Conners; Sayona John; Shyam Prabhakaran; Mehmet Kocak; Sudeep Bhabad; Sean L Simpson; Bichun Ouyang; Miral Jhaveri; Thomas P Bleck Journal: Neurocrit Care Date: 2020-10 Impact factor: 3.210
Authors: Antonio Nenna; Francesco Nappi; Mario Lusini; Umberto Maria Satriano; Davide Schilirò; Cristiano Spadaccio; Massimo Chello Journal: Biomed Res Int Date: 2021-01-23 Impact factor: 3.411