Abstract 116: Statin Therapy Is Associated With Decreased Risk of First Intracerebral Hemorrhage and Reduced 30-day Fatality: Results of a Nationwide Case-control Study Including 7696 Cases and 14 670 Controls

Abstract

Introduction: Statin therapy prevents vascular events, but an increased risk of intracerebral hemorrhage (ICH) has been reported. We assessed the hypothesis that statin therapy was associated with increased risk of ICH and increased mortality after ICH. Methods: Using data from comprehensive national registers in 2006 to 2009, we identified 7696 cases with first-event ICH in the Swedish Stroke Register and 14 670 sex- and age-matched stroke-free controls in the Swedish Population Register. Drug therapy at the time of ICH was identified through the Swedish Drug Prescription Register. The risk of ICH with statins was estimated using conditional logistic regression, adjusted for explanatory factors, such as hypertension, diabetes, and use of antithrombotic therapy. We investigated the association between statins and 30-day mortality among the 7696 ICH-cases using logistic regression analyses, adjusted for age and sex in addition to the other explanatory factors. Results: Statins were used by 1276 (16.6%) of the ICH-cases and by 2552 (17.4%) of the controls. The crude and adjusted odds ratios (OR) of ICH with statins were 0.94 (95% CI, 0.87-1.02) and 0.70 (95% CI, 0.64-0.76), respectively. The 1276 ICH-cases with statins at stroke onset were 2 years older, more often men and had more risk factors for stroke than the 6420 ICH-cases without stroke therapy. In the crude model, statins were not associated with decreased risk of 30-day mortality (1.13; 95% CI, 0.99-1.29). But in the adjusted model, statins were associated with reduced likelihood of death at 30 days (OR 0.80; 95% CI 0.69-0.94). Conclusions: This nationwide study demonstrates an association between statin therapy and decreased risk of ICH and short-term mortality. Given the widespread use of statin therapy in prevention of coronary heart disease, these findings are reassuring even though randomized trials of statin therapy in secondary stroke prevention still is required.