Statins may reduce risk of recurrent vascular events in young stroke patients

Young adults treated with a statin after a first ischemic stroke of undetermined cause were 77% less likely to suffer subsequent vascular events, according to a recent study published in Neurology.

To investigate the use of statins in young adults and their effect on the risk for subsequent vascular events, investigators at the Helsinki University Central Hospital selected 215 patients with an unknown etiology, comprehensive diagnostic evaluation, and information on statin use during the follow-up from a database of 1,008 consecutive patients aged 15 to 49 years with first-ever ischemic stroke between 1994 and 2007. The outcome measure was the composite vascular endpoint of any stroke, myocardial infarction (MI), or other arterial occlusive event, revascularization, or vascular death.

Investigators recorded statin use at discharge and at a later follow-up. If an outcome event or death occurred, the investigators recorded statin use prior to the event or prior to death if the death was due to something other than the defined vascular causes.

Of the 215 patients included, one third (33%) received a statin at some point after their stroke. Most patients took simvastatin (58%). These patients were likely to be older, have a poorer lipid profile, and have hypertension. Twenty-nine (20%) events occurred among the patients never on a statin. Those not treated with a statin were likely to be younger, have a more favorable lipid profile, and to exhibit a low frequency of traditional risk factors. There were no events among those on a continuous statin; there were 4 (11%) among those who had discontinued a statin. After adjustment for age, high blood pressure, and blood-pressure medication use, these patients were less likely to experience vascular events (HR=0.23; 95% CI, 0.08–0.66; P=.006).

The authors note that additional factors, such as more aggressive secondary prevention, may have played a role in the better outcome of the statin-treated patients. However, the authors concluded that unknown stroke etiology in a young adult should not prevent clinicians from initiating statin treatment.