Statin Initiation and early stroke recurrence in the POINT Trial Population

Abstract

Background and Purpose: Benefits of statin therapy in reducing the long-term risk of ischemic stroke are well-established, but the immediate effects of statin therapy on early stroke recurrence after an initial ischemic event are less clear. Methods: In this secondary analysis of POINT data, we evaluated the effects of statins on early stroke recurrence (within 7 days) and recurrence over 90 days. We also examined the effect of early statin initiation in the subgroup of subjects not on statins prior to the index event using logistic and proportional hazards models. Results: In the POINT trial, 175 of 267 (65.5%) of ischemic stroke recurrences were early (within 7 days). Baseline statin treatment at the time of study entry was marginally associated with a decrease in the odds of early ischemic stroke recurrence in adjusted logistical regression analysis (OR 0.70, 95% CI 0.50-0.99, p=0.04), but with a non-significant effect in adjusted Cox proportional hazard analysis (HR=0.72, 95% CI 0.52-1.01, p=0.05). In the subset of subjects not taking statin medications at baseline, initiation of statin treatment had no significant effect on the rate of early stroke recurrence (adjusted HR 0.80, 95% CI 0.54-1.20, p=0.22). Conclusion: In the POINT trial population, prior treatment with statin was weakly associated with decreased risk of early recurrence of stroke. However initiating statin treatment had no detectable effect in reducing risk of early stroke recurrence. The POINT trial provides no evidence for an immediate protective effect of statins against stroke recurrence.