Early lipid-lowering treatment improves post-stroke outcomes
MedWire News: Patients who suffer a stroke should be given lipid therapy before leaving hospital to reduce their risk for recurrent stroke, ischemic heart disease, or death, analysis of data from a major stroke registry has shown.
It has previously been shown that initiating lipid-lowering treatment soon after acute coronary syndromes improves outcomes and reduces the incidence of cardiovascular events.
It is also well established that individuals who survive an ischemic stroke are at increased risk for recurrent stroke and myocardial infarction.
Poh-Shiow Yeh (Chi-Mei Medical Center, Tainan, Taiwan) and colleagues therefore investigated whether lipid-lowering therapy improves outcomes when given immediately after a patient suffers an ischemic stroke.
To do this, the researchers reviewed data from the Taiwan Stroke Registry on 16,704 adults who suffered a transient ischemic attack or acute ischemic stroke, survived to discharge, and had not previously received lipid-lowering therapy.
Analysis revealed that 4032 (24%) of the patients were given lipid-lowering therapy before being discharged, a figure that the authors say highlights continued underuse of lipid-lowering therapies. Six months after discharge, 5.1% of these patients had experienced a second stroke, developed ischemic heart disease, or died.
This rate was significantly lower than that for patients who did not receive lipid-lowering treatment in the 6 months after discharge, at 7.6%.
Importantly, after controlling for potentially confounding factors, such as concomitant medication use, age, gender, and lipid levels, use of lipid-lowering therapy before discharge was still shown to have a significant beneficial effect on prognosis after discharge.
The authors conclude that their results highlight the importance of early lipid therapy following stroke and that delay of lipid-lowering therapy results in “lost opportunities” to improve patient outcomes.
Based on these findings, the authors reason that “it might be more important for all patients with acute ischemic stroke and transient ischemic attack to start lipid-lowering therapy during their hospital stay, rather than emphasizing the immediate use of lipid-lowering therapy during the very acute stage of the stroke.”
The results are reported in the American Journal of Cardiology.
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By Philip Ford