Deintensification or No Statin Treatment Is Associated With Higher Mortality in Patients With Ischemic Stroke or Transient Ischemic Attack.

Stroke; a Journal of Cerebral Circulation
Jennifer L Dearborn-TomazosJason J Sico

Abstract

Practice guidelines recommend that most patients receive moderate- or high-potency statins after ischemic stroke or transient ischemic attack (TIA) of atherosclerotic origin. We tested the association of different patterns of potency for prescribed statin therapy—assessed before admission and at hospital discharge for ischemic stroke or TIA—on mortality in a large, nationwide sample of US Veterans. The study population included patients with an ischemic stroke or TIA occurring during 2011 at any of the 134 Veterans Health Administration facilities. We used electronic outpatient pharmacy files to identify statin dose at hospital admission and within 7 days after hospital discharge. We categorized statin dosing as low, moderate, or high potency; moderate or high potency was considered at goal. We created 6 mutually exclusive groups to reflect patterns of statin potency from hospital admission to discharge: goal to goal, low to goal, goal to low or goal to none (deintensification), none to none, none to low, and low to low. We used logistic regression to compare 30-day and 1-year mortality across statin potency groups. The population included 9380 predominately White (71.1%) men (96.3%) who were hospitalized for stroke or TIA. In ...Continue Reading

References

Jul 1, 1976·The American Journal of Cardiology·W B KannelT Gordon
Nov 1, 1994·Journal of Clinical Epidemiology·M CharlsonJ Gold
Apr 13, 2001·JAMA : the Journal of the American Medical Association·G G SchwartzUNKNOWN Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators
Oct 16, 2002·Annals of Epidemiology·Diane C CowperDenise M Hynes
Oct 19, 2004·Atherosclerosis·Elia AscerCarlos V Serrano
Jul 11, 2006·Journal of Clinical Epidemiology·Robert J GlynnJerry Avorn
Aug 11, 2006·The New England Journal of Medicine·Pierre AmarencoUNKNOWN Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators
Mar 7, 2008·Stroke; a Journal of Cerebral Circulation·Robert J AdamsUNKNOWN American Stroke Association
Sep 15, 2012·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Jason J SicoDawn M Bravata
Dec 12, 2012·Current Atherosclerosis Reports·Patricia ManingatJan L Breslow
May 3, 2014·Stroke; a Journal of Cerebral Circulation·Walter N KernanUNKNOWN American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and
Jan 7, 2017·Circulation Research·Adam OesterleJames K Liao
Aug 22, 2017·JAMA Oncology·Louise EmilssonMiguel A Hernán
Feb 7, 2018·JAMA Neurology·Dawn M BravataEric Cheng
Aug 15, 2018·Neurology. Clinical Practice·Jason J SicoDawn M Bravata
Nov 19, 2019·The New England Journal of Medicine·Pierre AmarencoUNKNOWN Treat Stroke to Target Investigators

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.