Patients who have experienced ischaemic stroke often discontinue statin therapy or switch to a lower dose in the months following hospital discharge, but the consequences of this are unknown.
In a nationwide cohort study in the Journal of the American Heart Association (online, 2 August 2017), researchers used data from 45,151 patients in Taiwan, who received statins within 90 days of an ischaemic stroke
During the day 90 to day 180 post-stroke period, 7% were on reduced statin therapy and 18.5% were no longer receiving statins. Compared with statin therapy maintained at the same dose, discontinuation was associated with a 42% greater risk of recurrent stroke over the course of a year (adjusted hazard ratio 1.42, 95% CI 1.28–1.57). Meanwhile, reduced statin dosage had no impact on additional risk.
Discontinuation of statin therapy in patients between three and six months after ischaemic stroke should be strongly discouraged, the team conclude.