Statins and the Risk of Intracerebral Hemorrhage in Patients With Previous Ischemic Stroke or Transient Ischemic Attack

David Gaist, Larry B Goldstein, Lucía Cea Soriano, Luis Alberto García Rodríguez

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND AND PURPOSE: Although there is no overall association between statin use and intracerebral hemorrhage (ICH), whether there is an increased risk among those with a history of ischemic stroke (IS) or transient ischemic attack (TIA) remains controversial. We evaluated the relationship of preadmission statin use with the risk of ICH in patients with a history of IS or TIA in a population-based cohort.

METHODS: The Health Improvement Network primary care database in the United Kingdom was used to identify new users of low-dose aspirin and a matched comparison. Both cohorts were followed to identify incident cases of ICH, with validation by manual review of patient records and linkage to hospitalization data. In a nested case-control study, we compared the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for ICH based on statin use in the subgroup of individuals with history of IS/TIA.

RESULTS: Last statin use within 1 year of ICH (OR, 0.92; 95% CI [confidence interval], 0.60-1.4), last use between 8 days and 1 year (OR, 1.81; 95% CI, 0.99-3.28), and statin use at the time of ICH (OR, 0.77; 95% CI, 0.49-1.21) were not associated with the overall ICH risk among 157 patients with ICH and 884 controls with a history of IS/TIA. There was also no difference in 30-day rates of fatal (OR, 0.82; 95% CI, 0.41-1.64) or nonfatal (OR, 0.90; 95% CI, 0.51-1.57) ICH.

CONCLUSIONS: Statin use was not associated with an increased risk of ICH among patients with a previous history of IS/TIA.

Original languageEnglish
JournalStroke
Volume48
Issue number12
Pages (from-to)3245-3251
ISSN0039-2499
DOIs
Publication statusPublished - 2017

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Transient Ischemic Attack
Odds Ratio
Confidence Intervals
Case-Control Studies
Primary Health Care
Databases

Keywords

  • Journal Article

Cite this

Gaist, David ; Goldstein, Larry B ; Cea Soriano, Lucía ; García Rodríguez, Luis Alberto. / Statins and the Risk of Intracerebral Hemorrhage in Patients With Previous Ischemic Stroke or Transient Ischemic Attack. In: Stroke. 2017 ; Vol. 48, No. 12. pp. 3245-3251.
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title = "Statins and the Risk of Intracerebral Hemorrhage in Patients With Previous Ischemic Stroke or Transient Ischemic Attack",
abstract = "BACKGROUND AND PURPOSE: Although there is no overall association between statin use and intracerebral hemorrhage (ICH), whether there is an increased risk among those with a history of ischemic stroke (IS) or transient ischemic attack (TIA) remains controversial. We evaluated the relationship of preadmission statin use with the risk of ICH in patients with a history of IS or TIA in a population-based cohort.METHODS: The Health Improvement Network primary care database in the United Kingdom was used to identify new users of low-dose aspirin and a matched comparison. Both cohorts were followed to identify incident cases of ICH, with validation by manual review of patient records and linkage to hospitalization data. In a nested case-control study, we compared the adjusted odds ratios (ORs) with 95{\%} confidence intervals (CIs) for ICH based on statin use in the subgroup of individuals with history of IS/TIA.RESULTS: Last statin use within 1 year of ICH (OR, 0.92; 95{\%} CI [confidence interval], 0.60-1.4), last use between 8 days and 1 year (OR, 1.81; 95{\%} CI, 0.99-3.28), and statin use at the time of ICH (OR, 0.77; 95{\%} CI, 0.49-1.21) were not associated with the overall ICH risk among 157 patients with ICH and 884 controls with a history of IS/TIA. There was also no difference in 30-day rates of fatal (OR, 0.82; 95{\%} CI, 0.41-1.64) or nonfatal (OR, 0.90; 95{\%} CI, 0.51-1.57) ICH.CONCLUSIONS: Statin use was not associated with an increased risk of ICH among patients with a previous history of IS/TIA.",
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author = "David Gaist and Goldstein, {Larry B} and {Cea Soriano}, Luc{\'i}a and {Garc{\'i}a Rodr{\'i}guez}, {Luis Alberto}",
note = "{\circledC} 2017 American Heart Association, Inc.",
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Statins and the Risk of Intracerebral Hemorrhage in Patients With Previous Ischemic Stroke or Transient Ischemic Attack. / Gaist, David; Goldstein, Larry B; Cea Soriano, Lucía; García Rodríguez, Luis Alberto.

In: Stroke, Vol. 48, No. 12, 2017, p. 3245-3251.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Statins and the Risk of Intracerebral Hemorrhage in Patients With Previous Ischemic Stroke or Transient Ischemic Attack

AU - Gaist, David

AU - Goldstein, Larry B

AU - Cea Soriano, Lucía

AU - García Rodríguez, Luis Alberto

N1 - © 2017 American Heart Association, Inc.

PY - 2017

Y1 - 2017

N2 - BACKGROUND AND PURPOSE: Although there is no overall association between statin use and intracerebral hemorrhage (ICH), whether there is an increased risk among those with a history of ischemic stroke (IS) or transient ischemic attack (TIA) remains controversial. We evaluated the relationship of preadmission statin use with the risk of ICH in patients with a history of IS or TIA in a population-based cohort.METHODS: The Health Improvement Network primary care database in the United Kingdom was used to identify new users of low-dose aspirin and a matched comparison. Both cohorts were followed to identify incident cases of ICH, with validation by manual review of patient records and linkage to hospitalization data. In a nested case-control study, we compared the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for ICH based on statin use in the subgroup of individuals with history of IS/TIA.RESULTS: Last statin use within 1 year of ICH (OR, 0.92; 95% CI [confidence interval], 0.60-1.4), last use between 8 days and 1 year (OR, 1.81; 95% CI, 0.99-3.28), and statin use at the time of ICH (OR, 0.77; 95% CI, 0.49-1.21) were not associated with the overall ICH risk among 157 patients with ICH and 884 controls with a history of IS/TIA. There was also no difference in 30-day rates of fatal (OR, 0.82; 95% CI, 0.41-1.64) or nonfatal (OR, 0.90; 95% CI, 0.51-1.57) ICH.CONCLUSIONS: Statin use was not associated with an increased risk of ICH among patients with a previous history of IS/TIA.

AB - BACKGROUND AND PURPOSE: Although there is no overall association between statin use and intracerebral hemorrhage (ICH), whether there is an increased risk among those with a history of ischemic stroke (IS) or transient ischemic attack (TIA) remains controversial. We evaluated the relationship of preadmission statin use with the risk of ICH in patients with a history of IS or TIA in a population-based cohort.METHODS: The Health Improvement Network primary care database in the United Kingdom was used to identify new users of low-dose aspirin and a matched comparison. Both cohorts were followed to identify incident cases of ICH, with validation by manual review of patient records and linkage to hospitalization data. In a nested case-control study, we compared the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for ICH based on statin use in the subgroup of individuals with history of IS/TIA.RESULTS: Last statin use within 1 year of ICH (OR, 0.92; 95% CI [confidence interval], 0.60-1.4), last use between 8 days and 1 year (OR, 1.81; 95% CI, 0.99-3.28), and statin use at the time of ICH (OR, 0.77; 95% CI, 0.49-1.21) were not associated with the overall ICH risk among 157 patients with ICH and 884 controls with a history of IS/TIA. There was also no difference in 30-day rates of fatal (OR, 0.82; 95% CI, 0.41-1.64) or nonfatal (OR, 0.90; 95% CI, 0.51-1.57) ICH.CONCLUSIONS: Statin use was not associated with an increased risk of ICH among patients with a previous history of IS/TIA.

KW - Journal Article

U2 - 10.1161/STROKEAHA.117.019141

DO - 10.1161/STROKEAHA.117.019141

M3 - Journal article

C2 - 29070714

VL - 48

SP - 3245

EP - 3251

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 12

ER -