Statin Use Following Hemorrhagic Stroke Associated with Improved Survival

Patients who were treated with a statin in the hospital after suffering from a hemorrhagic stroke were significantly more likely to survive than those who were not, according to a study published September 22 in JAMA Neurology. This study was conducted by the same researchers who recently discovered that the use of cholesterol-lowering statins can improve survival in victims of ischemic stroke.

Ischemic stroke is caused by a constriction or obstruction of a blood vessel that blocks blood from reaching areas of the brain, while hemorrhagic stroke, also known as intracerebral hemorrhage, is bleeding in the brain.

"Some previous research has suggested that treating patients with statins after they suffer hemorrhagic stroke may increase their long-term risk of continued bleeding," said lead author Alexander Flint, MD, PhD, of the Kaiser Permanente Department of Neuroscience in Redwood City, Calif. "Yet the findings of our study suggest that stopping statin treatments for these patients may carry substantial risks."

The study included 3,481 individuals who were admitted to any of 20 Kaiser Permanente hospitals in Northern California with a hemorrhagic stroke over a 10-year period. Researchers looked at patient survival and discharge 30 days after the stroke.

Patients treated with a statin while in the hospital were more likely to be alive 30 days after suffering a hemorrhagic stroke than those who were not treated with a statin — 81.6 percent versus 61.3 percent. Patients treated with a statin while in the hospital were also more likely to be discharged to home or an acute rehabilitation facility than those who were not — 51.1 percent compared to 35.0 percent.

Patients whose statin therapy was discontinued — that is, patients taking a statin as an outpatient prior to experiencing a hemorrhagic stroke who did not receive a statin as an inpatient — had a mortality rate of 57.8 percent compared with a mortality rate of 18.9 percent for patients using a statin before and during hospitalization.

The researchers concluded that statin use is strongly associated with improved outcomes after hemorrhagic stroke, and that discontinuing statin use is strongly associated with worsened outcomes after hemorrhagic stroke.

Kaiser Permanente can conduct transformational health research in part because it has the largest private, patient-centered electronic health system in the world. The organization's electronic health record system, Kaiser Permanente HealthConnect®, securely connects approximately 9.5 million patients to more than 17,000 physicians in more than 600 medical offices and 38 hospitals. It also connects Kaiser Permanente's research scientists to one of the most extensive collections of longitudinal medical data available, facilitating studies and important medical discoveries that shape the future of health and care delivery for patients and the medical community.

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Kaiser Permanente   press release

Publication

Alexander C. Flint, Carol Conell, Vivek A. Rao, Jeff G. Klingman, Stephen Sidney, S. Claiborne Johnston, J. Claude Hemphill, Hooman Kamel, Stephen M. Davis, Geoffrey A. Donnan. Effect of Statin Use During Hospitalization for Intracerebral Hemorrhage on Mortality and Discharge Disposition.   JAMA Neurology, Published Online September 22 2014. doi: 10.1001/jamaneurol.2014.2124