Quitting statins after stroke may raise risk of another stroke

August 2, 2017, American Heart Association
Micrograph showing cortical pseudolaminar necrosis, a finding seen in strokes on medical imaging and at autopsy. H&E-LFB stain. Credit: Nephron/Wikipedia

Stroke patients who stopped taking statin drugs three to six months after a first ischemic stroke, the type caused by narrowed arteries, had a higher risk of a having another stroke within a year, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Researchers also found that discontinuing , which lower cholesterol, between three and six months after a first ischemic was linked to higher risk of death and hospitalization among the patients in the study.

Ischemic strokes—the most common type of stroke—may be caused by a buildup of cholesterol in the arteries, which blocks blood flow to brain. If LDL (low-density lipoprotein) cholesterol is too high, statin drugs can reduce the risk of a because they lower the artery clogging, "bad" LDL cholesterol.

Researchers studied people who had been hospitalized with stroke. All the participants received either high or moderate intensity statins within three months after they left the hospital. Compared to people who continued taking statins throughout the one-year follow-up period:

  • The risk of having another stroke increased 42 percent for patients who stopped taking statins.
  • There was no additional risk of having another stroke or death for patients who continued taking statins at a decreased dose.
  • The risk of death from any cause increased 37 percent after discontinuing statins.

"Based on our findings of this large group of patients in the "real world," we believe that statins should be a lifelong therapy for ischemic stroke patients if a statin is needed to lower the patient's cholesterol," said Meng Lee, M.D., lead author of the study and assistant professor of the Department of Neurology at Chang Gung University College of Medicine in Taiwan.

Researchers used medical data collected by the Taiwan National Health Insurance Program, which covers 99 percent of the population. The study population included 45,151 ischemic stroke patients between 2001 and 2012 who were prescribed a statin within 90 days after leaving the hospital. The study period included the three to six months following discharge, during which time 3,175 (7 percent) patients were on reduced statin therapy and 8,353 (18.5 percent) were not on any statin therapy.

The study was retrospective, meaning the researchers only used data from the patients' medical histories, so the researchers cannot determine why some stroke patients stopped taking statins.

However, Lee said recommendations by the Taiwan National Health Bureau to stop or reduce statins in stroke patients once the level of LDL-cholesterol is less than 100 mg/dl or total cholesterol of less than 160 mg/dl were achieved may have led to the discontinuation of statins for some of the patients in the study. Affordability of the medications was likely not a factor because the national health insurance in Taiwan covers all medication costs for eligible patients.

The American Heart Association recommends intensive statin therapy for patients who have had an ischemic stroke or TIA and who have an LDL-cholesterol level of more than 100 mg/dL, but does not recommend stopping statins based on achieving a specific LDL-cholesterol level in most people depending on individual risk.

Although the study was comprised entirely of patients from Taiwan, Lee said the results should be applicable to patients in the United States.

"Discontinuation of statin treatment in with should be strongly discouraged in any stage, acute or chronic, of stroke," Lee said. "Shifting to low-intensity therapy could be an alternative for not able to tolerate moderate or high intensity in the years following a stroke."

Explore further: Use of statins before cardiac arrest may aid survival afterwards

More information: Journal of the American Heart Association (2017). DOI: 10.1161/JAHA.117.005658

Related Stories

Use of statins before cardiac arrest may aid survival afterwards

November 12, 2016
Patients who have been taking statins are likely to survive longer after a cardiac arrest than those who are not taking them, according to research from Taiwan researchers presented during the Resuscitation Science Symposium ...

Study finds no link between intracerebral hemorrhage and statin use among patients with prior stroke

September 12, 2011
Among patients who have had an ischemic stroke, use of cholesterol-lowering statin medications is not associated with subsequent intracerebral hemorrhage (bleeding in the brain), according to a report published Online First ...

Poor response to cholesterol drugs may indicate blocked arteries

February 26, 2015
If your "bad" cholesterol level stays the same or increases after you take statin drugs, you may have more blocked arteries than people whose levels drop, according to research in the American Heart Association journal Arteriosclerosis, ...

Statin use during hospitalization for hemorrhagic stroke associated with improved survival

September 22, 2014
Patients who were treated with a statin in the hospital after suffering from a hemorrhagic stroke were significantly more likely to survive than those who were not, according to a study published today in JAMA Neurology. ...

Number of Americans taking statins keeps rising: CDC

December 23, 2014
(HealthDay)—More Americans than ever are taking cholesterol-lowering medications, federal health officials reported Tuesday.

Recommended for you

Study reveals a promising alternative to corticosteroids in acute renal failure treatment

September 21, 2018
A protein produced by the human body appears to be a promising new drug candidate to treat conditions that lead to acute renal failure. This is shown by a study conducted at São Paulo State University (UNESP) in São José ...

Can a common heart condition cause sudden death?

September 20, 2018
About one person out of 500 has a heart condition known as hypertrophic cardiomyopathy (HCM). This condition causes thickening of the heart muscle and results in defects in the heart's electrical system. Under conditions ...

New drugs could reduce risk of heart disease when added to statins

September 20, 2018
New drugs that lower levels of triglycerides (a type of fat) in blood could further reduce the risk of heart attack when added to statins. These new drugs, which are in various stages of development, could also reduce blood ...

Mediterranean-style diet may lower women's stroke risk

September 20, 2018
Following a Mediterranean-style diet may reduce stroke risk in women over 40 but not in men—according to new research led by the University of East Anglia.

Inflammation critical for preventing heart attacks and strokes, study reveals

September 19, 2018
Inflammation, long considered a dangerous contributor to atherosclerosis, actually plays an important role in preventing heart attacks and strokes, new research from the University of Virginia School of Medicine reveals.

People who walk just 35 minutes a day may have less severe strokes

September 19, 2018
People who participate in light to moderate physical activity, such as walking at least four hours a week or swimming two to three hours a week, may have less severe strokes than people who are physically inactive, according ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.