Statin therapy and the risk of intracerebral haemorrhage: a nationwide observational study

Abstract

Background: The association between statin therapy and intracerebral haemorrhage is still unclear. The aim was to investigate whether prior use of statin was associated with risk of intracerebral haemorrhage.

Methods: Between 2006 and 2009, we identified 7696 cases of intracerebral haemorrhage that were first-ever strokes in the Swedish Stroke Register and 14 670 stroke-free controls that were matched on age and gender in the Population Register. Drug therapy at the time of intracerebral haemorrhage was extracted from the Drug Prescription Register. The risk of intracerebral haemorrhage with statins was estimated by conditional logistic regression.

Results: In cases and controls, the median age was 73 years and 53% were men. Intracerebral haemorrhage cases had higher prevalence of antithrombotic therapy, hypertension, and diabetes than controls. Statins were used by 1276 (16·6%) of the intracerebral haemorrhage cases and by 2552 (17·4%) of the controls. The crude odds ratios of intracerebral haemorrhage did not differ significantly between patients with and without statins, but after adjustment for antithrombotic therapy, hypertension, and diabetes, patients with statins had a decreased risk of intracerebral haemorrhage (odds ratio = 0·68, 95% confidence interval, 0·63-0·74). The highest proportion (>20%) of antecedent statins was seen in the 70-84 age group, for both cases and controls.

Conclusions: In this matched case-controlled study, statin therapy was associated with a decreased risk of incident intracerebral haemorrhage. Future studies on risk of stroke with statin therapy after intracerebral haemorrhage are needed.

Keywords: SPARCL; epidemiology; intracerebral haemorrhage; prevention; risk factors; statins.