The time partitioned analysis did not lead to important changes to the results with regard to what factors are associated with statin use after stroke (Table S6). Researchers used medical data collected by the Taiwan National Health Insurance Program, which covers 99 percent of the population. •  Associations & Partners   2006;355:549–559. Social stratification in the dissemination of statins after stroke in sweden. doi:10.1016/S0140-6736(04)15690-0, 8. BMJ Open. I have read the AHA/ASA Multimedia Materials Usage Policy and agree to the terms of use, Scientific Publications: Purposes-Processes, Journal of the American Heart Association, http://newsroom.heart.org/news/quitting-statins-after-stroke-may-raise-risk-of-another-stroke?preview=3cec, AHA/ASA Multimedia Materials Usage Policy, Quitting statins after stroke may raise risk of another stroke. Post-stroke statin intensity was defined based on the highest intensity used within 2 years after stroke. Statin therapy is therefore now an established key component of secondary prevention after ischemic stroke.13,14 Some previous studies have explored persistence with statin therapy in the initial years after a stroke, and have suggested different factors that are associated with non-persistence, including age, polypharmacy, and comorbidity; most studies are not of sufficient size to explore all key factors, and it is also likely that patterns of use have changed over time.15–17 There are few recent published data on trend in and factors for statin use and dose after ischemic stroke. doi:10.1016/j.jacc.2017.02.064, 38. Javascript is currently disabled in your browser. Previous use of statins was strongly associated with statin use after ischemic stroke, with an HR of 2.36 (95% CI 2.30–2.42) in the fully adjusted model. Utility of electronic patient records in primary care for stroke secondary prevention trials. Accessed November 16, 2018. Patient characteristics were described for statin users and non-users. Quality control was performed before analysis (Table S3). In contrast, dementia, heart failure, and CLD were associated with the lowest statin use both before and after adjustment. The changes in statin use after stroke over this time period reflect changes in the clinical evidence and guidelines. doi:10.1016/S2214-109X(13)70089-5. Sensitivity analysis excluding unspecified stroke conformed to the main analysis, though reduced the power of the analysis (Table S7). The increase in high-intensity use reflects more recent guidelines, where high-intensity statins have been explicitly recommended for atherosclerotic cardiovascular disease, including ischemic stroke.9–11 The availability of generic atorvastatin, whose patent expired in 2011, may have contributed to the increase in the use of high-intensity statins (however, this did not influence the cost to patients, as all UK prescriptions cost a standard charge, from which almost all stroke patients are exempt). This study examines how statin prescribing after stroke has changed over time between 2000 and 2014 in a large representative sample of the UK general population, and explores factors associated with both statin use and with high-intensity statin use. State of the Nation: stroke statistics. By accessing the work you hereby accept the Terms. Eur J Clin Pharmacol. doi:10.1016/j.cardiores.2006.04.011, 42. You’ll also be advised to take a statin if you’re considered to be at significant risk of developing cardiovascular disease, or of having a heart attack or stroke. Effect of rosuvastatin in patients with chronic heart failure (the gissi-hf trial): A randomised, double-blind, placebo-controlled trial. To ensure the quality of recording of pre-existing diagnoses and medications, eligible patients were also required to have at least 12-month record information before the index date. Cardiovascular disease: risk assessment and reduction, including lipid modification; 2014. Clinical trials and policy interventions to improve appropriate post-stroke statin use should focus on younger and older patients, patients with no pre-stroke statin treatment, and patients without additional cardiovascular risk factors.Keywords: cerebral ischemia, lipid-lowering, trend, factors, Stroke remains one of the leading causes of death and disability in the UK and worldwide.1,2 While incidence and mortality rates are declining in developed countries such as the UK and the USA, related to improvements in health care and public health, post-stroke survival is also increasing, expanding the population in need of effective secondary prevention of recurrent strokes and cardiovascular events.3,4 Ischemic stroke accounts for 80–90% of stroke in the UK,5 and statins can reduce the risk of stroke and cardiovascular events in these patients.6, Evidence supporting the benefits of statins after ischemic stroke has come in particular from two large-scale randomized controlled trials, the Heart Protection Study (HPS)7 published in 2004 and the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL)8 in 2006. We conducted a retrospective cohort study using the Clinical Practice Research Datalink (CPRD), which provides anonymized data extracted from primary care medical records (including community prescribing information), with coverage of a representative sample of approximately 7% of the UK population from more than 670 practices.18. Lancet. It’s possible for some people to stop taking statins safely, but it can be especially risky for others. These conditions were also associated with high-intensity statin use (final three columns in Table 2), from 8% to 58% higher than the relevant reference group in the full model. Likewise, previous use of high-intensity statins was strongly associated with high-intensity statin use after ischemic stroke, with an RR of 4.47 (95% CI 4.51–4.99). From submission to first editorial decision. Chen PS, Cheng CL, Kao Yang YH, Li YH. doi:10.3399/bjgp18X695465, 22. There were similar trends in the proportion of statin users and high-intensity statin users between specified ischemic and unspecified stroke, with slightly higher usage in the specified group for each calendar year (Figure S1). Key data on the benefits of statins after ischemic stroke were published between 2000 and 2006.7,8 Afterward, the proportion of stroke patients on statins was stable at 70–75% during the period that targets were in place for UK family doctors. Lancet. Abbreviations: CPRD, clinical practice: a retrospective cohort study of patients! Than a half of stroke patients at hospital discharge in australia called edema, is part Taylor! Stroke linked to a degenerative brain condition coronary artery disease statin if used post-stroke. Between 2001 and 2012 who were prescribed alternative lipid-lowering drugs within a month, he said a. Of chronic heart failure ( the gissi-hf trial ): a retrospective cohort study slightly afterward, it stable. 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