Statins still effective in older stroke patients, reducing the risk of cardiovascular events and death

Statin therapy following an ischemic stroke is beneficial for patients 80 years old and older, according to new research published in Stroke.

“Statin therapy has been proven effective in preventing cardiovascular disease recurrence after a stroke in patients below the age of 80 years,” wrote lead author Geert J. Lefeber, MD, of UMC Utrecht in the Netherlands, and colleagues. “However, clinical practice clearly lacks evidence on the benefits of statin therapy after the age of 80 years.”

Hoping to shed more light on this topic, Lefeber’s team examined data from nearly 6,000 patients in the U.K. who experienced an ischemic stroke from January 1999 to February 2016. More than 3,000 of those patients were 80 years old or older at the time of treatment. For each patient, the team was able to review medical history information for at least one full year before the ischemic stroke.

Patients with a prior stroke or myocardial infarction (MI) were excluded. Statins prescribed to these patients included atorvastatin, fluvastatin, pravastatin, rosuvastatin, and simvastatin.

Overall, the team found, two years of statin prescription was “significantly associated” with a lower risk of a recurrent stroke, a MI, cardiovascular mortality or all-cause mortality.

“Guidelines give limited recommendations on the initiation and discontinuation of statin treatment in older patients,” the authors wrote. “Current evidence should be better implemented in guidelines and local poststroke protocols. In case of a positive decision regarding initiation of statins, efforts should be made to keep patients adherent to statins for at least 2 years regardless of a patient’s age, except when the prognosis of the patient clearly deteriorates during these 2 years.”

The full study is available here.