The Impact of Pre- and Post-Stroke Statin Use on Stroke Severity and Long-Term Outcomes: A Population-Based Cohort Study

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Background: The benefit of statins on stroke incidence is well known. However, data on the relationship between pre and post stroke statin use, recurrence and survival outcomes are limited. We aim to investigate the short-term and long-term relationship between statin prescription, stroke recurrence and survival in patients with first-ever ischemic stroke.
Methods: Data were collected from the population-based South London Stroke Register for the years 1995-2015. Patients were assessed at time of first ever stroke, three months and annually thereafter. Data on vascular risk factors, treatments prescribed, socio-demographic characteristics, stroke subtype, survival and stroke recurrence were collected. Cox proportional hazard analyses were used to assess the relationship of statin prescriptions pre- and post-stroke on stroke severity, and long-term recurrence and survival.
Results: Patients prescribed statins both pre- and post-stroke showed a 24% reduction in mortality (adjusted Hazard Ratio aHR=0.76, 0.60-0.97), those who were prescribed statins pre-stroke and then stopped post stroke showed greater risk of mortality (aHR=1.85, 1.10-3.12) and stroke recurrence (aHR=3.25, 1.35-7.84) compared to those that were not prescribed statins at any time. No associations were observed between pre-stroke statin and severity of the initial stroke overall, though a protective effect against moderate/severe stroke (Glasgow Coma Scale≤12) was observed in those aged 75y+ (aOR=0.70, 0.52-0.95)
Conclusions: Statins play a significant role in improving survival rates after a stroke. Adherence to the National Guidelines that promote statin treatment primary and secondary prevention of stroke should be monitored and a focus for quality improvement programs.
Original languageEnglish
Pages (from-to)260-267
Number of pages8
Issue number5-6
Early online date16 Jul 2019
Publication statusPublished - 1 Sept 2019


  • Recurrence
  • Statin
  • Stroke
  • Survival


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