Early statin therapy reduces all-cause mortality in acute hemorrhagic stroke patients without prior statin use

Objectives: The benefit of statin therapy in primary and secondary prevention for acute ischemic stroke is demonstrated. However, whether statin therapy is associated with better clinical outcome in patients with acute hemorrhagic stroke (HS) is still uncertain. We assess the effect of early statin therapy on acute HS patients without prior statin use. Methods and results: We screened the databank of the Bureau of National Health Insurance in Taiwan from January 2008 to December 2008. Patients who were admitted for their new HS and without prior statin therapy within 3 months before admission were included in this study. The patients (n=859, mead age 63±15.4 years, male 62.6%) receiving statin treatment during hospitalization or within 3 months after discharge were recognized as early statin use group and the others (n=9,947, mead age 63±15.6 years, male 62.9%) were defined as control group. The study end point was the all-cause mortality rate during the follow-up period. All eligible patients were followed up until 31 December, 2010 after discharge. Cox proportional hazards analyses and matched propensity score analyses were used to evaluate the effect of early statin therapy on all-cause mortality. During the follow-up period, 2,116 patients met the study end point: 109 (12.7%) in early statin use group, and 2,007 (20.2%) in control group. Patients in early statin use group had less all-cause mortality rate (adjusted hazard ratio (HR): 0.74; 95% confidence interval (CI): 0.61 – 0.90, p < 0.001) when compared with control group. Moreover, the results of matched propensity score analyses were consistent with the findings of Cox proportional hazards analyses (adjusted HR: 0.70; 95% CI: 0.53 – 0.92, p = 0.02). Conclusions: Our study showed that acute HS patients with early statin use had lower all-cause mortality rate and the results implied the beneficial effect of statin therapy on clinical outcome of HS.