Abstract TP378: Statin Use among Patients with Intracerebral Hemorrhage in the Paul Coverdell National Acute Stroke Registry

Abstract

Background: Various studies have produced conflicting results on whether statins increase the risk of intracerebral hemorrhage (ICH) yet many studies show a protective effect for those on statins at the time of acute ischemic stroke (AIS). This study assesses the characteristics and outcomes of patients having intracerebral hemorrhage and statin use in the Paul Coverdell National Acute Stroke Registry (PCNASR). Methods: There were 103,491patients with AIS and 16,319 with ICH enrolled in the PCNASR during 2009-2011. Chi-square tests were used to test for association of clinical characteristics with ICH and ICH with statin use. Logistic regression analysis was used to assess factors associated with odds of ICH vs. AIS and mortality among ICH patients. Results: Of 16,319 patients with ICH, 5,522 were on statins at the time of ICH (33.8%). Among ICH patients, mean age was 72.8 for statin users (S) and 65.3 for non-statin users (NS) (p<0.0001). Median NIHSS score was 7 for ICH on S and 9 for ICH among NS (p=0.002). Mean LDL cholesterol was 101 among ICH and 102 among AIS (p=0.28). Statin use was associated with less ICH (AOR 0.82, CI 0.79, 0.85). Statin users with ICH had higher prevalence of hypertension, atrial fibrillation, ischemic heart disease, heart failure, diabetes, carotid stenosis, cardiac valve prosthesis, taking antithrombotics, antihypertensives, or prior stroke compared to NS with ICH (p<0.0001 for all). Among ICH patients, adjusted analyses showed males, older age, NIHSS score, cardiac valve prosthesis (CVP) and antithrombotic use were associated with increased in-hospital mortality, while statin use was not associated with in-hospital mortality (AOR 0.97, CI 0.80,1.16) (Table). Conclusions: Mortality among patients with ICH was greatest among those with CVP or on antithrombotics. Statin use was associated with less severe ICH, but not with ICH in-hospital mortality.