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04-08-2011 | Vascular medicine | Article

Statins may prevent recurrent stroke in young patients


Free abstract

MedWire News: Prescribing statins to young stroke survivors may reduce their risk for subsequent vascular events, even if the stroke etiology is unclear, researchers report in the journal Neurology.

"Because the cause of stroke in young people can be hard to identify, cholesterol-lowering drugs are often not used to prevent further strokes or vascular problems," said lead study author Jukka Putaala (Helsinki University Central Hospital, Finland), in a press statement.

"This study suggests that the drugs should be considered even when the cause of the stroke is unknown and the cholesterol levels are not high."

Putaala and team identified 215 patients, aged an average of 39 years, who had stroke with an undetermined etiology. A third of these patients had used a statin at some point during follow-up lasting an average of 9.0 years.

Initial stroke severity and stroke subtype by the TOAST classification were similar between statin users and nonusers. However, patients given a statin had significantly more vascular risk factors than those not given statins.

Specifically, statin users were older than patients not given a statin, at 42.5 versus 37.3 years, and had significantly higher levels of total and low-density lipoprotein cholesterol and of triglycerides. They were also more likely to have hypertension, at 47.2% versus 14.7%, and coronary heart disease, at 4.2% versus 0.0%.

Yet none of the 36 patients on continuous statin therapy during follow-up had a vascular event, defined as any of stroke, myocardial infarction, other arterial thrombosis, revascularization, or vascular death.

By contrast, four (11%) vascular events occurred among the 36 patients with irregular statin use and 29 (20%) occurred among the 143 never given a statin.

Overall, any statin use was associated with a 77% reduction in the risk for vascular events among the young stroke patients, after accounting for age, gender, vascular risk factors, medication, year of index stroke, and a propensity score quantifying the likelihood of patients being given a statin.

"While the study may be limited by the small number of people who were treated with a statin, at the very least, young adults who have experienced a stroke for unknown reasons should be considered for treatment with cholesterol-lowering drugs," said Putaala.

By Eleanor McDermid

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