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Use of Statins After Ischemic Stroke in Young Adults and Its Association With Long-Term Outcome.

Journal article
Authors Myrna Marita Elisabeth van Dongen
Karoliina Aarnio
Nicolas Martinez-Majander
Jani Pirinen
Juha Sinisalo
Mika Lehto
Markku Kaste
Turgut Tatlisumak
Frank-Erik de Leeuw
Jukka Putaala
Published in Stroke
Volume 50
Issue 12
Pages 3385-3392
ISSN 1524-4628
Publication year 2019
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 3385-3392
Language en
Links dx.doi.org/10.1161/STROKEAHA.119.02...
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords adolescent, brain ischemia, cardiovascular diseases, dyslipidemias, follow-up studies
Subject categories Neurology

Abstract

Background and Purpose- Knowledge of the use of secondary preventive medication in young adults is limited. We studied the use of statins and its association with subsequent vascular events in young adults with ischemic stroke-a patient group with a known low burden of atherosclerosis. Methods- The study population included 935 first-ever 30-day ischemic stroke survivors aged 15 to 49 years from the Helsinki Young Stroke Registry, 1994 to 2007. Follow-up data until 2012 were obtained from the Social Insurance Institution of Finland (Drug Prescription Register), the Finnish Care Register, and Statistics Finland. The association of the use of statins (defined as at least 2 purchases) with all-cause mortality, recurrent stroke, and other recurrent vascular events was assessed through adjusted Cox regression analyses. We further compared propensity score-matched statin users with nonusers. Results- Of our 935 patients, 46.8% used statins at some point during follow-up. Higher age, dyslipidemia, heavy alcohol use, and hypertension were significantly associated with purchasing statins. Statin users exhibited lower risk of all-cause mortality (hazard ratio, 0.38 [95% CI, 0.25-0.58]) and recurrent stroke (hazard ratio, 0.29 [95% CI, 0.19-0.44]) than nonusers, after adjustment for dyslipidemia, stroke subtype, and other confounders. These results remained unchanged after propensity score-matched comparison. Conclusions- Less than half of young ischemic stroke patients used statins; use was affected by age and risk factor profile. Statin use was independently associated with lower risk of all-cause mortality and recurrent stroke.

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