Cholesterol-lowering statins such as Pfizer Inc.’s Lipitor helped boost survival in patients who had a stroke caused by bleeding in the brain, a study from Kaiser Permanente showed.
Hemorrhagic stroke patients given a statin while in the hospital had about double the chance of survival compared to those not given the drugs, according to research today in the journal JAMA Neurology. Those already taking the drugs and who stayed on them in the hospital were three times more likely to survive after a stroke than those whose medicine was stopped.
Doctors have been concerned that statins could make bleeding worse in hemorrhagic strokes. The review of 3,481 patients over 10 years showed the opposite. Taking a statin improved survival and discharge to home or to a rehabilitation facility, said Randolph Marshall, who wrote an accompanying editorial in the journal. An earlier study by the same group of researchers found statins also helped patients who had an ischemic stroke, where blood can’t reach part of the brain.
“It is a new concept for most clinicians that statins are actually safe to use and actually beneficial in the setting of ischemic stroke and hemorrhagic stroke,” said Marshall, a professor of neurology and chief of the Stroke Division at Columbia University Medical Center in New York. “My hope is that doctors will take this to heart and understand the potential benefits of statins moving forward.”
Further study would be needed to confirm the findings, he said.
Largest Study
Today’s findings are the largest ever such study, according to the researchers. While the primary use for statins is to lower cholesterol, the drugs can also improve blood flow and reduce inflammation, which may be beneficial in stroke patients, Marshall said in a telephone interview.
Researchers included patients who were admitted to 20 Kaiser Permanente hospitals in Northern California with a hemorrhagic stroke over a 10-year period. They looked at patient survival and discharge 30 days after the stroke.
Of patients who weren’t already on statins and got the drugs at the hospital after a stroke, 18 percent were dead after 30 days, compared with 39 percent of those who didn’t get a statin at all. Patients given the cholesterol treatments were discharged to home or a rehabilitation facility more than half the time, versus 35 percent of those not given the statin.
“If a patient is taking a statin when they come into a hospital with a hemorrhagic stroke, they should strongly consider not stopping the statin immediately in the hospital,” said lead study author Alexander Flint, a stroke specialist at Kaiser Permanente in Redwood City, California, in a telephone interview.
Future studies need to look at how long patients need to remain on these statin therapies, he said.
The study also showed that patients already taking statins who stopped after arriving at the hospital following a stroke had a 58 percent chance of dying with 30 days, compared with 19 percent for those whose statin therapy was continued.
Those whose therapy was continued were discharged home or to a rehabilitation facility about half the time, compared with 22 percent of those whose medicine was stopped.
This article was originally published in Bloomberg Businessweek on Sept. 23, 2014
