Data from: Statin therapy in acute cardioembolic stroke with no guidance-based indication

Objective It is uncertain if patients with cardioembolic stroke and
absence of a guidance-based indication for statin therapy should be
administered a statin for prevention of subsequent vascular events. This
study was performed to determine whether the statin therapy is beneficial
to prevent major vascular events in this population. Methods Using a
prospective multicenter stroke registry database, we identified acute
cardioembolic stroke patients who were hospitalized between 2008 and 2015.
Patients who had other established indications for statin therapy
according to current guideline were excluded. Major vascular event was
defined as a composite of stroke recurrence, myocardial infarction and
vascular death. We performed frailty model analysis with the robust
sandwich variance estimator using the stabilized inverse probability of
treatment weighting method to estimate hazard ratios of statin therapy on
outcomes. Results Of 6,124 cardioembolic stroke patients, 2,888 (male,
44.6%; mean age, 75.3 years with 95% confidence interval 74.8-75.8) were
eligible; and 1,863 (64.5%) were on statin therapy during hospitalization.
After a median follow-up of 359 days, cumulative incidences of major
vascular events were 9.3% in the statin users and 20.5% in the non-users
(p <0.001 by log-rank test). The adjusted hazard ratios of statin
therapy was 0.39 (95% confidence interval, 0.31-0.48) for major vascular
events; 0.81 (0.57-1.16) for stroke recurrence; 0.28 (0.21-0.36) for
vascular death; and 0.53 (0.45-0.61) for all-cause death, respectively.
Conclusion Starting statin during acute stage of ischemic stroke
may reduce the risk of major vascular events, vascular death and all-cause
death in cardioembolic stroke patients with no guidance-based indication
for statin.