Statin Use During Ischemic Stroke Hospitalization Is Strongly Associated With Improved Poststroke Survival

• DOI: 10.1161/strokeaha.111.627729
• Publication Date: 2011-10-22T00:17:27Z
• Authors: Alexander C. Flint; Hooman Kamel; Babak B. Navi; Vivek A. Rao; Bonnie S. Faigeles; Carol Conell; Jeff G. Klingman; Stephen Sidney; Nancy K. Hills; Michael Sorel; Sean P. Cullen; S. Claiborne John...
• Keywords: Stroke

Background and Purpose— Statins reduce infarct size in animal models of stroke have been hypothesized to improve clinical outcomes after ischemic stroke. We examined the relationship between statin use before during hospitalization poststroke survival. Methods— analyzed records from 12 689 patients admitted with any 17 hospitals a large integrated healthcare delivery system January 2000 December 2007. used multivariable survival analysis grouped-treatment analysis, an instrumental variable method that uses treatment differences facilities avoid individual patient-level confounding. Results— Statin was associated improved (hazard ratio, 0.85; 95% CI, 0.79–0.93; P <0.001), better rates 0.59; 0.53–0.65; <0.001). Patients taking their who underwent withdrawal hospital had substantially greater risk death 2.5; 2.1–2.9; The benefit for high-dose (>60 mg/day) 0.43; 0.34–0.53; <0.001) than lower dose (<60 0.60; 0.54–0.67; <0.001; test trend earlier in-hospital further Grouped-treatment showed association cannot be explained by Conclusions— early is strongly survival, hospital, even brief period, worsened