Use of Statins After Stroke Increasing Slowly

But one in five still leaves hospital without this evidence-based treatment
By Lindsey Marcellin
HealthDay Reporter

FRIDAY, May 28 (HealthDay News) -- The percentage of stroke patients given prescriptions for evidence-based statin treatment at hospital discharge has increased over time, but nearly one in five still leaves the hospital without a prescription, according to research published online May 27 in Stroke.

Bruce Ovbiagele, M.D., of the Ronald Reagan—UCLA Medical Center in Los Angeles, and colleagues analyzed data from 173,284 hospitalized ischemic stroke and transient ischemic attack patients from the American Heart Association/American Stroke Association's Get With The Guidelines—Stroke nationwide quality improvement registry during the period 2005 through 2007. They also looked for trends in statin prescribing related to the landmark Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study.

Overall, 83.5 percent of patients received statin treatment at hospital discharge. During the two-year study period, the researchers found that rates of statin prescribing rose at a steady pace, beginning at 75.7 percent and ending at 84.8 percent. There was a nonsignificant uptick in statin prescriptions at the time of the SPARCL study publication (which returned to prior levels afterward). Women had lower odds of receiving a statin than did men, and those in the southern United States had lower odds than those in other regions.

"The lack of a significant effect of SPARCL reporting on discharge statin treatment prescription in hospitalized patients with ischemic stroke and transient ischemic attack may have been because clinicians had already made up their minds regarding the effectiveness of statin use before publication of SPARCL based on indirect evidence supporting benefit for statins in reducing vascular events after stroke," the authors write. "Our multivariable analyses showed that many avenues on the patient- and hospital-level could be explored to enhance discharge statin treatment rates further."

The study was supported in part by unrestricted educational grants to the AHA by Pfizer Inc., and the Merck-Schering Plough Partnership. Study authors disclosed financial ties to these and other pharmaceutical companies.

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