Statin initiation and early stroke recurrence in the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial (POINT) trial population.

BACKGROUND

Benefits of statin therapy in reducing the long-term risk of ischemic stroke are well-established, but the immediate protective effect of statin therapy on risks of early stroke recurrence after an initial ischemic event are not established.

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 associated with decreased odds of early ischemic stroke recurrence in adjusted logistical regression analysis (OR 0.70, 95 % CI 0.50-0.99, P = 0.04), an effect only marginally significant in adjusted Cox proportional hazard analyses (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 protective effect against early stroke recurrence (adjusted HR 0.80, 95 % CI 0.54-1.20, P = 0.28).

CONCLUSIONS

In the POINT trial population, prior treatment with statin was marginally associated with decreased odds 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 statin initiation against early stroke recurrence.