One in five not receiving statins after US hospital discharge for stroke
MedWire News: One in five eligible stroke patients is still being discharged from US hospitals without statin treatment, although prescription rates have been improving, research suggests.
Interestingly, there was no significant increase in statin prescriptions following results from the landmark Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial showing its benefits in patients with recent symptomatic cerebrovascular disease.
Lead researcher Bruce Ovbiagele (University College of Los Angeles, California, USA) warned that approximately one in 10 patients experiences another stroke within a week.
He said: “The hospital encounter provides a window of opportunity to ensure prompt and appropriate initiation of treatments, such as statins, that could prevent another stroke.”
The study included 173,284 patients with ischemic stroke or transient ischemic attack (TIA) treated at hospitals taking part in the Get With The Guidelines-Stroke national quality improvement registry between January 2005 and December 2007.
Overall, 83.5% of these patients received statin treatment at hospital discharge, with rates rising steadily from 75.7% to 84.8% over the course of the study.
Women had 13% lower odds of receiving a statin compared with men, and hospitals in the South of the USA had 34% lower odds than those in the West of the country.
There was a nonsignificant increase in statin prescriptions at discharge when the SPARCL study was reported before a return to prior levels, the researchers write in the journal Stroke.
Ovbiagele said: “While statin use after stroke improved over time, 16.5% of eligible stroke patients still leave the hospital without statin treatment, which unnecessarily exposes them to the risk of another stroke.”
He added that hospitals involved in the quality improvement registry may be particularly motivated to provide optimal stroke care, and that national statin treatment rates at discharge could be worse than those in the study.
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By Anita Wilkinson