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Statin use and sex-specific stroke outcomes in patients with vascular disease.

Publication ,  Journal Article
Bushnell, CD; Griffin, J; Newby, LK; Goldstein, LB; Mahaffey, KW; Graffagnino, CA; Harrington, RA; White, HD; Simes, RJ; Califf, RM; Topol, EJ ...
Published in: Stroke
June 2006

BACKGROUND AND PURPOSE: Although statins reduce the risk of stroke in patients with coronary heart disease, possible differing effects of statins on stroke outcomes based on sex remain uncertain. We investigated the relationships between statin use and sex-specific stroke incidence, severity, and mortality. METHODS: Data from 3 trials of oral glycoprotein IIb/IIIa inhibitors (first and second Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes [SYMPHONY] and Blockade of the glycoprotein IIb/IIIa Receptor to Avoid Vascular Occlusion [BRAVO]) were pooled and stroke outcomes compared among 8191 baseline statin users versus 14,752 nonusers. Time-to-event data were modeled with proportional hazards regression. Stroke severity was assessed retrospectively with the Canadian Neurological Scale (CNS) based on records with scoreable neurological examinations. RESULTS: A total of 217 subjects had strokes (0.95%). Statin users had a lower risk of stroke in unadjusted (hazard ratio [HR], 0.69; 95% CI, 0.51 to 0.92) and risk-adjusted models (HR, 0.72; 95% CI, 0.53 to 0.97). There was no difference in stroke mortality with statin use (P=0.8). CNS scores could be assigned to 106 of the subjects, with no difference in severity among statin users and nonusers (median CNS=10.5 in users versus CNS=9.75 in nonusers; P=0.14). Women had more severe strokes than men (median CNS=10.5 in men versus 9.5 in women; Poisson regression P=0.035). Women had more severe strokes after adjustment for statin use (P=0.03) and the combination of statin use, atrial fibrillation, and age (P=0.03). CONCLUSIONS: In patients included in these clinical trials of oral glycoprotein IIb/IIIa inhibitors, statin use is associated with a reduced risk of stroke but not severity or mortality. Women had more severe strokes than men, a difference that was not explained by baseline characteristics or statin use.

Duke Scholars

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

June 2006

Volume

37

Issue

6

Start / End Page

1427 / 1431

Location

United States

Related Subject Headings

  • Vascular Diseases
  • Stroke
  • Sex Characteristics
  • Severity of Illness Index
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Proportional Hazards Models
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Neurology & Neurosurgery
  • Middle Aged
 

Citation

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Bushnell, C. D., Griffin, J., Newby, L. K., Goldstein, L. B., Mahaffey, K. W., Graffagnino, C. A., … Easton, J. D. (2006). Statin use and sex-specific stroke outcomes in patients with vascular disease. Stroke, 37(6), 1427–1431. https://doi.org/10.1161/01.STR.0000221315.60282.ca
Bushnell, Cheryl D., Jeffrey Griffin, L Kristin Newby, Larry B. Goldstein, Kenneth W. Mahaffey, Carmelo A. Graffagnino, Robert A. Harrington, et al. “Statin use and sex-specific stroke outcomes in patients with vascular disease.Stroke 37, no. 6 (June 2006): 1427–31. https://doi.org/10.1161/01.STR.0000221315.60282.ca.
Bushnell CD, Griffin J, Newby LK, Goldstein LB, Mahaffey KW, Graffagnino CA, et al. Statin use and sex-specific stroke outcomes in patients with vascular disease. Stroke. 2006 Jun;37(6):1427–31.
Bushnell, Cheryl D., et al. “Statin use and sex-specific stroke outcomes in patients with vascular disease.Stroke, vol. 37, no. 6, June 2006, pp. 1427–31. Pubmed, doi:10.1161/01.STR.0000221315.60282.ca.
Bushnell CD, Griffin J, Newby LK, Goldstein LB, Mahaffey KW, Graffagnino CA, Harrington RA, White HD, Simes RJ, Califf RM, Topol EJ, Easton JD. Statin use and sex-specific stroke outcomes in patients with vascular disease. Stroke. 2006 Jun;37(6):1427–1431.

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

June 2006

Volume

37

Issue

6

Start / End Page

1427 / 1431

Location

United States

Related Subject Headings

  • Vascular Diseases
  • Stroke
  • Sex Characteristics
  • Severity of Illness Index
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Proportional Hazards Models
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Neurology & Neurosurgery
  • Middle Aged