title: Statins and risk of poststroke hemorrhagic complications.
abstract: OBJECTIVE
  To assess whether statin treatment before or after acute ischemic stroke (AIS) affects the risk of acute intracerebral hemorrhage (ICH), postacute ICH, and mortality within 90 days.
  
  
  METHODS
  Data were sought from the Virtual International Stroke Trials Archive, an international repository of clinical trials data. Using propensity score matching, we retrospectively compared patients with prior statin treatment and newly initiated statin within 3 days after AIS to patients without statin exposure. Outcomes of interest were acute symptomatic ICH (sICH), any acute ICH, postacute ICH, and mortality during follow-up of 3 months.
  
  
  RESULTS
  A total of 8,535 patients (mean age 70 years, 54% male, median baseline NIH Stroke Scale score 13) were analyzed. After propensity score matching, prior statin use was not strongly associated with sICH (adjusted odds ratio [OR] 1.33, 95% confidence interval [CI] 0.83-2.14) or any ICH (adjusted OR 1.35, 95% CI 0.92-1.98). There was no evidence of an interaction between prior statin use and thrombolysis. New initiation of statins was not associated with postacute ICH (adjusted hazard ratio [HR] 1.60, 95% CI 0.70-3.65). There was a signal towards lower 90-day mortality in patients with prior statin use (adjusted HR 0.84, 95% CI 0.70-1.00) and especially early initiation of statins (adjusted HR 0.67, 95% CI 0.46-0.97).
  
  
  CONCLUSIONS
  Statin use prior to AIS was not associated with early hemorrhagic complications, irrespective of treatment with thrombolysis. New initiation of statin treatment early after AIS did not affect risk of postacute ICH, but might be associated with reduced mortality.
authors.affiliation: From the Center for Stroke Research Berlin (J.F.S., B.S., M.E., C.H.N.), Klinik für Neurologie (J.F.S., M.E., C.H.N.), Clinical Epidemiology and Health Services Research in Stroke (CEHRiS) (B.S.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charité-Universitätsmedizin Berlin, Germany; Stroke Research (R.L.M., A.H.A.-R., K.R.L.), Institute of Cardiovascular & Medical Sciences, University of Glasgow; and Stroke Trials Unit (P.M.B.), Division of Clinical Neuroscience, University of Nottingham, UK. jan-friedrich.scheitz@charite.de.
authors.forename: Jan F
authors.initials: JF
authors.lastname: Scheitz
authors.affiliation: From the Center for Stroke Research Berlin (J.F.S., B.S., M.E., C.H.N.), Klinik für Neurologie (J.F.S., M.E., C.H.N.), Clinical Epidemiology and Health Services Research in Stroke (CEHRiS) (B.S.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charité-Universitätsmedizin Berlin, Germany; Stroke Research (R.L.M., A.H.A.-R., K.R.L.), Institute of Cardiovascular & Medical Sciences, University of Glasgow; and Stroke Trials Unit (P.M.B.), Division of Clinical Neuroscience, University of Nottingham, UK.
authors.forename: Rachael L
authors.initials: RL
authors.lastname: MacIsaac
authors.affiliation: From the Center for Stroke Research Berlin (J.F.S., B.S., M.E., C.H.N.), Klinik für Neurologie (J.F.S., M.E., C.H.N.), Clinical Epidemiology and Health Services Research in Stroke (CEHRiS) (B.S.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charité-Universitätsmedizin Berlin, Germany; Stroke Research (R.L.M., A.H.A.-R., K.R.L.), Institute of Cardiovascular & Medical Sciences, University of Glasgow; and Stroke Trials Unit (P.M.B.), Division of Clinical Neuroscience, University of Nottingham, UK.
authors.forename: Azmil H
authors.initials: AH
authors.lastname: Abdul-Rahim
authors.affiliation: From the Center for Stroke Research Berlin (J.F.S., B.S., M.E., C.H.N.), Klinik für Neurologie (J.F.S., M.E., C.H.N.), Clinical Epidemiology and Health Services Research in Stroke (CEHRiS) (B.S.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charité-Universitätsmedizin Berlin, Germany; Stroke Research (R.L.M., A.H.A.-R., K.R.L.), Institute of Cardiovascular & Medical Sciences, University of Glasgow; and Stroke Trials Unit (P.M.B.), Division of Clinical Neuroscience, University of Nottingham, UK.
authors.forename: Bob
authors.initials: B
authors.lastname: Siegerink
authors.affiliation: From the Center for Stroke Research Berlin (J.F.S., B.S., M.E., C.H.N.), Klinik für Neurologie (J.F.S., M.E., C.H.N.), Clinical Epidemiology and Health Services Research in Stroke (CEHRiS) (B.S.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charité-Universitätsmedizin Berlin, Germany; Stroke Research (R.L.M., A.H.A.-R., K.R.L.), Institute of Cardiovascular & Medical Sciences, University of Glasgow; and Stroke Trials Unit (P.M.B.), Division of Clinical Neuroscience, University of Nottingham, UK.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Bath
authors.affiliation: From the Center for Stroke Research Berlin (J.F.S., B.S., M.E., C.H.N.), Klinik für Neurologie (J.F.S., M.E., C.H.N.), Clinical Epidemiology and Health Services Research in Stroke (CEHRiS) (B.S.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charité-Universitätsmedizin Berlin, Germany; Stroke Research (R.L.M., A.H.A.-R., K.R.L.), Institute of Cardiovascular & Medical Sciences, University of Glasgow; and Stroke Trials Unit (P.M.B.), Division of Clinical Neuroscience, University of Nottingham, UK.
authors.forename: Matthias
authors.initials: M
authors.lastname: Endres
authors.affiliation: From the Center for Stroke Research Berlin (J.F.S., B.S., M.E., C.H.N.), Klinik für Neurologie (J.F.S., M.E., C.H.N.), Clinical Epidemiology and Health Services Research in Stroke (CEHRiS) (B.S.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charité-Universitätsmedizin Berlin, Germany; Stroke Research (R.L.M., A.H.A.-R., K.R.L.), Institute of Cardiovascular & Medical Sciences, University of Glasgow; and Stroke Trials Unit (P.M.B.), Division of Clinical Neuroscience, University of Nottingham, UK.
authors.forename: Kennedy R
authors.initials: KR
authors.lastname: Lees
authors.forename: Christian H
authors.initials: CH
authors.lastname: Nolte
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000401:mortality*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors