Featured Research

from universities, journals, and other organizations

Study finds no link between intracerebral hemorrhage and statin use among patients with prior stroke

Date:
September 12, 2011
Source:
JAMA and Archives Journals
Summary:
Among patients who have had an ischemic stroke, use of cholesterol-lowering statin medications is not associated with subsequent intracerebral hemorrhage (bleeding in the brain), according to a new study.

Among patients who have had an ischemic stroke, use of cholesterol-lowering statin medications is not associated with subsequent intracerebral hemorrhage (bleeding in the brain), according to a report published Online First by Archives of Neurology, one of the JAMA/Archives journals.

According to background information in the article, after stroke or transient ischemic attack, patients are at increased risk for recurrent events. Results from the Stroke Prevention by Aggressive Lowering of Cholesterol Levels (SPARCL) trial and the Heart Protection Study (HPS) were used to develop clinical practice guidelines which recommend therapy with statins to prevent further cerebrovascular problems. The authors note that this treatment appears to be associated with a reduced risk of ischemic stroke in those patients. However, they add, "together these two trials suggest a sizable increase in hemorrhagic stroke related to statin therapy in patients with a history of stroke or transient ischemic attack, a finding reported in two widely cited systematic reviews."

Daniel G. Hackam, M.D., Ph.D., from the University of Western Ontario, London, Ontario, Canada, and colleagues, conducted a retrospective study of six Canadian health care databases. They included 17,872 patients age 66 years and older who were admitted to Ontario hospitals for acute ischemic stroke from July 1994 to March 2008. Equal numbers of patients did not receive statins (control group) and did receive statins (intervention group). Patients were followed from 120 days after hospital discharge until they developed intracerebral hemorrhage (ICH), died or reached the March 31, 2010 endpoint of the study; the median (midpoint) follow-up time was 4.2 years.

Researchers found 213 episodes of ICH; the rate was slightly lower in patients treated with statins (2.94 vs. 3.71 episodes per 1,000 patient-years, respectively), but the difference was not statistically significant. Strokes were hemorrhagic in 10.09 percent of patients receiving statins and 10.23 percent of patients in the control group. Analysis of patient subgroups and statin dosage, and of screening tests that could indicate a healthy user bias or differences in quality of care, also did not demonstrate an association between medication use and ICH.

"At present, more than 80 percent of patients discharged from the hospital with a diagnosis of ischemic stroke are prescribed statin therapy," note the authors. "In a large North American jurisdiction, we found no evidence that such patients are at higher risk for cerebral bleeding than individuals who do not receive statins. Physicians should continue to adhere to current treatment guidelines recommending statin therapy for most patients with a history of ischemic stroke."

Editorial: Statin Use and Intracerebral Hemorrhage

In an editorial, Philip B. Gorelick, M.D., M.P.H., from the University of Illinois College of Medicine, Chicago, discusses the results of the study by Hackam and colleagues in the context of other research about the effects of statin therapy on stroke and brain hemorrhage. "In clinical practice, the controversy over the administration of statins after stroke centers on the subsequent risk of brain hemorrhage in patients who might benefit from a reduction in major ischemic vascular events with statin therapy," he writes. Next, Gorelick outlines the results of other research addressing this question: "The HPS and SPARCL trial results suggest that there may be a signal of increased risk of brain hemorrhage with statin administration after stroke, whereas the Hackam et al findings diverge from this message." Gorelick suggests that differences in and limitations of the various study designs may help explain the discrepancy.

"Until we have additional, high-level evidence to clarify the statin-ICH [intracerebral hemorrhage] risk relationship, I recommend careful control of modifiable risks for brain hemorrhage such as blood pressure in those who are treated with a statin," Gorelick recommends. "The clinical decision to administer a statin following ICH remains a challenging one with available evidence tilting in the direction of withholding such therapy, especially when there is a history of lobar brain hemorrhage." Input from patients and family members who have been informed of the risks may help in deciding whether to pursue treatment with statins, he adds.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Daniel G. Hackam; Peter C. Austin; Anjie Huang; David N. Juurlink; Muhammad M. Mamdani; J. Michael Paterson; Vladimir Hachinski; Ping Li; Moira K. Kapral. Statins and Intracerebral Hemorrhage: A Retrospective Cohort Study. Archives of Neurology, 2011; DOI: 10.1001/archneurol.2011.228
  2. Philip B. Gorelick. Statin Use and Intracerebral Hemorrhage: Evidence for Safety in Recurrent Stroke Prevention? Archives of Neurology, 2011; DOI: 10.1001/archneurol.2011.234

Cite This Page:

JAMA and Archives Journals. "Study finds no link between intracerebral hemorrhage and statin use among patients with prior stroke." ScienceDaily. ScienceDaily, 12 September 2011. <www.sciencedaily.com/releases/2011/09/110912164012.htm>.
JAMA and Archives Journals. (2011, September 12). Study finds no link between intracerebral hemorrhage and statin use among patients with prior stroke. ScienceDaily. Retrieved August 30, 2014 from www.sciencedaily.com/releases/2011/09/110912164012.htm
JAMA and Archives Journals. "Study finds no link between intracerebral hemorrhage and statin use among patients with prior stroke." ScienceDaily. www.sciencedaily.com/releases/2011/09/110912164012.htm (accessed August 30, 2014).

Share This




More Mind & Brain News

Saturday, August 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Treadmill 'trips' May Reduce Falls for Elderly

Treadmill 'trips' May Reduce Falls for Elderly

AP (Aug. 28, 2014) Scientists are tripping the elderly on purpose in a Chicago lab in an effort to better prevent seniors from falling and injuring themselves in real life. (Aug.28) Video provided by AP
Powered by NewsLook.com
Alice in Wonderland Syndrome

Alice in Wonderland Syndrome

Ivanhoe (Aug. 27, 2014) It’s an unusual condition with a colorful name. Kids with “Alice in Wonderland” syndrome see sudden distortions in objects they’re looking at or their own bodies appear to change size, a lot like the main character in the Lewis Carroll story. Video provided by Ivanhoe
Powered by NewsLook.com
Stopping Schizophrenia Before Birth

Stopping Schizophrenia Before Birth

Ivanhoe (Aug. 27, 2014) Scientists have long called choline a “brain booster” essential for human development. Not only does it aid in memory and learning, researchers now believe choline could help prevent mental illness. Video provided by Ivanhoe
Powered by NewsLook.com
Personalized Brain Vaccine for Glioblastoma

Personalized Brain Vaccine for Glioblastoma

Ivanhoe (Aug. 27, 2014) Glioblastoma is the most common and aggressive brain cancer in humans. Now a new treatment using the patient’s own tumor could help slow down its progression and help patients live longer. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins