title: Statin use after intracerebral hemorrhage: a 10-year nationwide cohort study.
abstract: Although statin therapy is beneficial to patients with ischemic stroke, statin use, and intracerebral hemorrhage (ICH) remain a concern. ICH survivors commonly have comorbid cardiovascular risk factors that would otherwise warrant cholesterol-lowering medication, thus emphasizing the importance of assessing the characteristics of statin therapy in this population.
  
  
  
  We performed a cohort study by using 10 years of data collected from the National Health Insurance Research Database in Taiwan. We enrolled 726 patients admitted for newly diagnosed ICH from January 1, 2001 to December 31, 2010. The patients were categorized into high- (92), moderate- (545), and low-intensity (89) statin groups, and into hydrophilic (295) and lipophilic (431) statin groups. The composite outcomes included all-cause mortality, recurrent ICH, ischemic stroke, transient ischemic attack, and acute coronary events.
  
  
  
  The patients in the low-intensity group did not differ significantly from the patients in the high-intensity group in risk of all-cause mortality (adjusted hazard ratio [aHR] = 0.65, 95% confidence interval [CI] = 0.28-1.55) and recurrent ICH (aHR = 0.66, 95% CI = 0.30-1.44). In contrast, the patients in the hydrophilic group had a significantly lower risk of recurrent ICH than did those in the lipophilic group (aHR = 0.69, 95% CI = 0.48-0.99). We determined no significant differences in other composite endpoints between hydrophilic and lipophilic statin use.
  
  
  
  Hydrophilic statin therapy is associated with a reduced risk of recurrent ICH in post-ICH patients. The intensity of statin use had no significant effect on recurrent ICH or other components of the composite outcome. Additional studies are required to clarify the biological mechanisms underlying these observations.
authors.affiliation: Department of Family Medicine School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan; Department of Family Medicine Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan; Department of Family Medicine Kaohsiung Municipal Ta-Tung Hospital Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan.
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Tai
authors.affiliation: Department of Neurology Kaohsiung Medical University Hospital Kaohsiung Taiwan; Department of Neurology Pingtung Hospital Ministry of Health and Welfare Pingtung Taiwan.
authors.forename: Feng-Cheng
authors.initials: FC
authors.lastname: Lin
authors.affiliation: Department of Family Medicine Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan.
authors.forename: Chung-Yin
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Family Medicine School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan; Department of Family Medicine Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan; Department of Family Medicine Kaohsiung Municipal Hsiao-Kang Hospital Kaohsiung Medical University Kaohsiung Taiwan.
authors.forename: Chai-Jan
authors.initials: CJ
authors.lastname: Chang
authors.affiliation: Department of Family Medicine School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan; Department of Public Health Kaohsiung Medical University Kaohsiung Taiwan; Center of Environmental and Occupational Medicine Kaohsiung Municipal Hsiao-Kang Hospital Kaohsiung Medical University Kaohsiung Taiwan.
authors.forename: Ming-Tsang
authors.initials: MT
authors.lastname: Wu
authors.affiliation: Department of Otorhinolaryngology School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan; Department of Otorhinolaryngology Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan; Department of Otorhinolaryngology Kaohsiung Municipal Hsiao-Kang Hospital Kaohsiung Medical University Kaohsiung Taiwan.
authors.forename: Chen-Yu
authors.initials: CY
authors.lastname: Chien
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D012008:Recurrence; D012306:Risk; D012995:Solubility; D013624:Taiwan / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Intensity; intracerebral hemorrhage; solubility; statin