“Our study shows that long-term use of statins is more protective against stroke than short-term use,” said study author Jiayi Huang, a doctoral student at the University of Hong Kong in China.
is the most common heart rhythm disorder affecting more than 40 million people worldwide. Patients with the condition are five times more likely to have a stroke than their peers.
In those with atrial fibrillation, the drug is recommended to prevent stroke, but it does not completely eliminate the risk. Statin therapy is widely prescribed to lower blood cholesterol and reduce the risk of heart attack and stroke. However, the benefit of statins for stroke prevention in patients with atrial fibrillation is unclear.
The researchers used the Hong Kong Clinical Data Analysis and Reporting System to identify all patients with a new diagnosis of atrial fibrillation between 2010 and 2018. Participants were divided into two groups: statin users and non-users. Users took a statin for at least 90 consecutive days during the year after diagnosis of atrial fibrillation.
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The primary outcomes were the composite endpoint of ischemic stroke or systemic embolism; hemorrhagic stroke; and transient ischemic attack. Patients were followed until October 31, 2022, the primary outcome, death, or the end of the study.
Statins: Key to reducing stroke risk in patients
A total of 51,472 patients with a new diagnosis of atrial fibrillation were included, of whom 11,866 were classified as statin users and 39,606 as non-users. The average age of the participants was 75 and 48% were women. At a median follow-up of five years, statin users had a significantly lower risk of all primary outcomes compared with nonusers. Statin use was associated with a 17% reduced risk of ischemic stroke or systemic embolism (hazard ratio). [HR] 0.83; 95% confidence interval [CI] 0.78-0.89), a 7% reduction in the risk of hemorrhagic stroke (HR 0.93; 95% CI 0.89-0.98) and a 15% reduction in the risk of transient ischemic attack (HR 0.85; 95% CI 0 .80-0.90).
The researchers also found that long-term use of statins was associated with greater protection than short-term use. The risk of ischemic stroke or systemic embolism was reduced by 43% (HR 0.57; 95% CI 0.54–0.61) in patients taking statins for six years or more, compared with those taking the drug for three to two years. reduced risk of hemorrhagic stroke (HR 0.56; 95% CI 0.53–0.60) and transient ischemic attack by 42% (HR 0.58; 95% CI 0.52–0.64). These associations were consistent regardless of whether patients were using anticoagulant drugs or the type of anticoagulant.
The findings have important clinical implications, especially given that ischemic strokes are often fatal or disabling and have a high risk of recurrence in patients with atrial fibrillation.
Source: Eurekalert
