Early statin use for secondary prevention in patients with atrial fibrillation and recent ischaemic stroke
Published Date: 15th May 2024
Publication Authors: Hill. AM, Irving G, Abdul-Rahim. A
Poster presentation for the ESOC 2024. Full conference programme available here: https://apps.congrex.com/esoc2024/en-GB/pag/
Background and aims
We investigated the benefits of early statin use for secondary prevention of ischaemic stroke (IS) in patients with AF.
Methods
We conducted a propensity score matched analysis using data within TriNetX, a global federated healthcare database, comparing patients with AF and recent IS, who received statins within 28 days of their index stroke with those who did not. Primary outcomes included the 2-year risk of recurrent IS and major adverse cardiovascular events (MACE). Secondary outcomes included the 2-year risk of transient ischaemic attack (TIA), and intracranial haemorrhage (ICH).
Results
We identified 20,902 patients with AF and recent IS, of whom 7,500 (35.9%) received statins within 28 days of their stroke and 13,402 (64.1%) did not. We included 11,182 well-matched patients (mean age 73.7±11.5; 5,277 (47.2%) female). Patients who received early statins had significantly lower risk of the primary and secondary outcomes, including recurrent IS (Hazard Ratio [HR]: 0.45, 95% Confidence Interval [CI]: 0.41–0.48, p<0.001), MACE (HR: 0.48, 95%CI: 0.45-0.52, p<0.001), TIA (HR: 0.37, 95%CI: 0.30-0.44, p<0.001), and ICH (HR: 0.59, 95%CI: 0.47-0.72, p<0.001 ) (Figure.1). Subgroup analyses (Figure.2) using: (1) patients with optimal LDL-cholesterol; (2) low, moderate and high intensities of statins; and (3) lipophilic vs hydrophilic statins demonstrated a lower risk of recurrent IS. A significant reduction in ICH was only observed in the lipophilic subgroup (vs. hydrophilic subgroup).
Conclusions
Early statin use may have an important role in secondary prevention of recurrent stroke and MACE (including ICH) in patients with AF and recent ischaemic stroke.
Choi, S; Hill, A; Irving, G; Abdul-Rahim, A et al. (2024). Early statin use for secondary prevention in patients with atrial fibrillation and recent ischaemic stroke. Conference poster from 10th European Stroke Organisation Conference, 15-17 May 2024, Basel, Switzerland.
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