title: Statins after ischemic stroke of undetermined etiology in young adults.
abstract: OBJECTIVE
  To investigate the use of statins and their effect on the risk for subsequent vascular events in young adults with ischemic stroke of undetermined etiology.
  
  
  METHODS
  From our database of 1,008 consecutive patients aged 15-49 with first-ever ischemic stroke between 1994 and 2007 (mean follow-up in survivors 9.0 ± 4.0 years), we selected those with an unknown etiology, comprehensive diagnostic evaluation, and information on statin use during the follow-up. The 3 groups of statin users were never used, continuous use, and discontinuous use. The outcome event was the composite endpoint of stroke, myocardial infarction, other arterial thrombosis, revascularization, or vascular death.
  
  
  RESULTS
  Of the 215 patients included (mean age 39.1 ± 8.6 years), 72 (33%) used a statin at some time during follow-up. These patients were likely to be older, have a poorer lipid profile, and have hypertension. Twenty-nine (20%) events occurred among the 143 patients never on a statin, none among the 36 with continuous statin, and 4 (11%) among the 36 with discontinuous statin. In a Cox proportional hazards analysis adjusted for age, sex, dyslipidemia, hypertension, antihypertensive medication, stroke year, and propensity score, patients on a statin at any time during follow-up were less likely to experience outcome events (hazard ratio 0.23, 95% confidence interval 0.08-0.66; p = 0.006).
  
  
  CONCLUSIONS
  Young patients with a first ischemic stroke of undetermined etiology who used statin poststroke had lower rates of new vascular events in a long-term follow-up.
authors.affiliation: Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. jukka.putaala@hus.fi
authors.forename: Jukka
authors.initials: J
authors.lastname: Putaala
authors.forename: Elena
authors.initials: E
authors.lastname: Haapaniemi
authors.forename: Markku
authors.initials: M
authors.lastname: Kaste
authors.forename: Turgut
authors.initials: T
authors.lastname: Tatlisumak
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D002546:Ischemic Attack, Transient / Q000150:complications*; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality; D055815:Young Adult
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors