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High-Dose Statins May Not Benefit Patients With Mild Ischemic Stroke
Compared with moderate-dose therapy, high-dose statin therapy in patients with mild ischemic stroke did not decrease the risk of stroke recurrence and was associated with an increased risk of intracranial hemorrhage over 12 months, according to a study published in the Journal of the American Heart Association.
“This cohort study suggests that compared with moderate‐intensity statin therapy, high‐intensity statin medication in the acute period may not positively influence clinical outcome of patients with minor, noncardiogenic ischemic stroke,” wrote corresponding author Xiao‐yuan Niu, MD, of the First Hospital of Shanxi Medical University in Taiyuan, China, and study coauthors.
The prospective study included patients with mild ischemic stroke who received care within 72 hours of symptom onset at 8 hospitals in China. Researchers grouped patients by statin dose and compared outcomes between the high-intensity and moderate-intensity statin treatment groups. The study included 3-month data for 2950 patients and 12-month data for 2764 patients.
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There was no discernible difference in stroke recurrence rates between the high- and moderate-dose statin groups for the main efficacy outcome of stroke recurrence, according to the study. Additionally, high-dose statin therapy was not associated with decreased occurrence of ischemic stroke or compound vascular events, both secondary efficacy outcomes, compared with moderate-dose therapy.
High-intensity statin therapy was linked, however, with an increased risk of intracranial hemorrhage, which was the study’s primary safety end point. Researchers reported adjusted hazard ratios of 1.81 at 3 months and 1.86 at 12 months.
The study also identified a trend suggesting that high‐intensity statins may benefit patients with a history of coronary heart disease.
“Given that the sample size in the present study was modest,” researchers wrote, “additional research is required to determine the role of intensive statin therapy in stroke patients with known coronary heart disease.”
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