September 22, 2014

Statin use after stroke associated with improved survival

OAKLAND, Calif. — Patients who were treated with a statin in the hospital after suffering from a hemorrhagic stroke were significantly more likely to survive than those who were not, according to a study published today in JAMA Neurology. This study was conducted by the same researchers who recently discovered that the use of cholesterol-lowering statins can improve survival in victims of ischemic stroke.

Ischemic stroke is caused by a constriction or obstruction of a blood vessel that blocks blood from reaching areas of the brain, while hemorrhagic stroke, also known as intracerebral hemorrhage, is bleeding in the brain.

“Some previous research has suggested that treating patients with statins after they suffer hemorrhagic stroke may increase their long-term risk of continued bleeding,” said lead author Alexander Flint, MD, PhD, of the Kaiser Permanente Department of Neuroscience in Redwood City, Calif. “Yet the findings of our study suggest that stopping statin treatments for these patients may carry substantial risks.”

The study included 3,481 individuals who were admitted to any of 20 Kaiser Permanente hospitals in Northern California with a hemorrhagic stroke over a 10-year period. Researchers looked at patient survival and discharge 30 days after the stroke.

Patients treated with a statin while in the hospital were more likely to be alive 30 days after suffering a hemorrhagic stroke than those who were not treated with a statin — 81.6 percent versus 61.3 percent. Patients treated with a statin while in the hospital were also more likely to be discharged to home or an acute rehabilitation facility than those who were not — 51.1 percent compared to 35.0 percent.

Patients whose statin therapy was discontinued — that is, patients taking a statin as an outpatient prior to experiencing a hemorrhagic stroke who did not receive a statin as an inpatient — had a mortality rate of 57.8 percent compared with a mortality rate of 18.9 percent for patients using a statin before and during hospitalization.

The researchers concluded that statin use is strongly associated with improved outcomes after hemorrhagic stroke, and that discontinuing statin use is strongly associated with worsened outcomes after hemorrhagic stroke.

Kaiser Permanente can conduct transformational health research in part because it has the largest private, patient-centered electronic health system in the world. The organization’s electronic health record system, Kaiser Permanente HealthConnect®, securely connects approximately 9.5 million patients to more than 17,000 physicians in more than 600 medical offices and 38 hospitals. It also connects Kaiser Permanente’s research scientists to one of the most extensive collections of longitudinal medical data available, facilitating studies and important medical discoveries that shape the future of health and care delivery for patients and the medical community.

Other authors on the paper include Vivek Rao, MD, of the Department of Neuroscience, Kaiser Permanente, Redwood City, Calif.; Carol Conell, PhD, and Stephen Sidney, MD, MPH, of the Kaiser Permanente Division of Research in Oakland, Calif.; Jeff Klingman, MD, of the Department of Neurology, Kaiser Permanente, Walnut Creek, Calif.; Claiborne Johnston, MD, PhD, of Dell Medical School, University of Texas at Austin; Claude Hemphill, MD, of the Department of Neurology, University of California at San Francisco; Hooman Kamel, MD, of the Department of Neurology, Weill Cornell Medical College, New York; Stephen Davis, MD, FRACP, of the Department of Neurology, Royal Melbourne Hospital, Victoria, Australia; and Geoffrey Donnan, MD, FRACP, Victoria, Australia.

The present study was supported by a grant from the Kaiser Foundation Research Institute Community Benefit Program.

About Kaiser Permanente Division of Research

The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 500-plus staff is working on more than 250 epidemiological and health services research projects. For more information, visit or follow us @KPDOR.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve approximately 9.5 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health.