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The Role of Statin Therapy in Hemorrhagic Stroke
Author(s) -
Sikora Newsome Andrea,
Casciere Bryan C.,
Jordan J. Dedrick,
Rhoney Denise H.,
Sullivan Kelly A.,
Morbitzer Kathryn A.,
Moore Joseph D.,
Durr Emily A.
Publication year - 2015
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1674
Subject(s) - medicine , intracerebral hemorrhage , statin , discontinuation , stroke (engine) , observational study , subarachnoid hemorrhage , disease , intensive care medicine , mechanical engineering , engineering
The 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase inhibitors (statins) are the most widely utilized class of cholesterol‐lowering agents, carrying multiple indications for both primary and secondary cardiovascular risk reduction. Concern was raised by previously published post hoc analyses and observational studies that noted an increased risk of hemorrhagic stroke in patients receiving a statin. Subsequent studies have demonstrated conflicting results regarding the role of statin therapy on hemorrhagic stroke risk and patient outcomes. New evidence suggests that statins taken prior to or continued during admission for intracerebral hemorrhage (ICH) may be associated with positive outcomes. Evidence also suggests deleterious outcomes resulting from the abrupt discontinuation of statins upon hospital admission for multiple disease states including ICH. Conflicting data also exist for the use of statins following aneurysmal subarachnoid hemorrhage (aSAH). Recent evidence suggests statins started during admission for aSAH confer no additional benefit in reducing delayed ischemic neurologic deficits despite initial positive results. Larger scale evaluation of the role of statin therapy following hemorrhagic stroke is warranted. The available literature is reviewed to provide guidance for therapeutic decision making.