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Acute ischaemic stroke: intensive statin therapy may increase the risk for discontinuation

Intensive statin therapy may significantly increase the risk for early discontinuation of therapy compared with moderate statin therapy in the secondary prevention of ischaemic stroke or transient ischaemic attack (TIA), according to a study published in the journalClinical Therapeutics.

Researchers evaluated 505 consecutive hospitalised patients with ischaemic stroke or TIA, of whom 64 received intensive statin therapy and 441 received moderate statin therapy. Association between statin therapy intensity and discontinuation after discharge was assessed by using logistic regression model.

During the mean follow-up of 6 months the rate of discontinuation was significantly higher in patients who received intensive statin therapy vs moderate statin therapy (31.3% vs 10.7%; P<.001). Among patients with National Institutes of Health Stroke Scale scores (NIHSS) ≤4, the risk for discontinuation significantly increased in intensive statin therapy vs moderate statin therapy groups (37.7% vs 10.6%; P<.001), whereas it remained consistent between both the therapy groups among patients with NIHSS scores ≥4 (0% vs 10.8%; P=.595). Both univariate and multivariate logistic regression analyses showed an increased discontinuation risk by 273.0% (OR=3.730; 95% CI, 2.013-6.911; P<.001) in patients receiving intensive statin therapy vs moderate statin therapy. In all subgroups and especially in patients with a history of diabetes, the risk for discontinuation was higher in the intensive statin therapy vs moderate statin therapy (OR=20.461; 95% CI, 4.788-87.428; P<.001).

Authors said, “More randomised controlled trials are needed to assess disparity in discontinuation rates between intensive and moderate statin therapy for secondary stroke prevention.”


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