Abstract P660: Statin Therapy is Associated With Lower Mortality One Year After Ischemic Stroke: A National Data Linkage Study

Abstract

Introduction: Statins significantly reduce the risk of fatal and non-fatal cardiovascular events in patients with atherosclerotic cardiovascular disease and other high-risk conditions. Current guidelines strongly recommend the use of statins in all eligible patients after an ischaemic stroke, but some patient groups (e.g. elderly, female) still miss out, suggesting more evidence of benefit is still needed. Aim: To investigate the effect of statins on one-year mortality outcomes in ischaemic stroke survivors. Methods: This retrospective study linked routinely collected health data from the Scottish Stroke Care Audit (SSCA), the Prescribing Information System (PIS) and the Scottish Morbidity Record (SMR) 01 and mortality data from the National Records of Scotland (NRS). The study population included patients from January 2010 to December 2015 who survived an ischaemic stroke. Statin therapy was defined as at least one statin prescription within six months of the stroke event (yes/no) and data modelled to analyse the effect on mortality outcomes up to one year. Data were analysed using Cox proportional hazards in SPSS version 25. Results: The study population included 24 499 patients discharged from hospital to their usual place of residence within thirty days after an incident ischaemic stroke and who survived to six months. Statins were prescribed to 21 356 (87.2%) within the first six months in the community setting. Patients on a statin were more likely to be younger [median age 71.2 (IQR 61.1 to 79.5) versus 73.2 (IQR 55.5 to 83.2) years] and male (53.7% versus 46.3%) but had similar Charlson Comorbidity Index scores compared with patients not prescribed a statin. Post stroke statin therapy significantly reduced the risk of death [HR 0.49 (95% confidence interval 0.41 to 0.59)] when adjusted for age, sex, prior statin therapy and baseline stroke severity. Separate analysis also revealed similar benefits regardless of age and sex. Conclusion: Post-stroke statin therapy was associated with a reduced risk of death within one year even accounting for age, sex or comorbidities. This reinforces the benefit of current guideline implementation.