TY - JOUR
T1 - Withdrawal of Statins and Risk of Subarachnoid Hemorrhage
AU - Risselada, Roelof
AU - Straatman, H
AU - van Kooten, Fop
AU - Dippel, Diederik
AU - van der Lugt, Aad
AU - Niessen, Wiro
AU - Firouzian, Azadeh
AU - Herings, RMC (Ron)
AU - Sturkenboom, MCJM
PY - 2009
Y1 - 2009
N2 - Background and Purpose-Vascular endothelium, which can be affected by statins, is believed to play a substantial role in subarachnoid hemorrhage (SAH). Our objective was to estimate the association between use and withdrawal of statins and the risk of SAH. Methods-We conducted a population-based case-control study within the PHARMO database. A case was defined as a person hospitalized for SAH (ICD-9-CM code 430) in the period January 1, 1998 to December 31, 2006. Ten randomly chosen controls were matched to each case on age, gender, and calendar date. Results-During the study period 1004 incident cases of SAH were identified. Current use of statins did not significantly decrease the risk of SAH (OR = 0.77, 95% CI 0.55 to 1.07). The odds ratio for recent withdrawal compared to nonusers was 1.62 (95% CI 0.96 to 2.73). Compared to current use, recent withdrawal was associated with an increased risk of SAH (OR = 2.34, 95% CI 1.35 to 4.05). Interaction analysis showed that the effect of statin withdrawal was highest in patients who had also recently stopped antihypertensive drugs (OR = 6.77, 95% CI 2.10 to 21.8). Conclusions-Current use of statins seems to lower the risk of SAH, although the reduction was not significant in new users. Statin withdrawal increased the risk of SAH by a factor 2, even more in patients who had also recently stopped their antihypertensive treatment. (Stroke. 2009; 40: 2887-2892.)
AB - Background and Purpose-Vascular endothelium, which can be affected by statins, is believed to play a substantial role in subarachnoid hemorrhage (SAH). Our objective was to estimate the association between use and withdrawal of statins and the risk of SAH. Methods-We conducted a population-based case-control study within the PHARMO database. A case was defined as a person hospitalized for SAH (ICD-9-CM code 430) in the period January 1, 1998 to December 31, 2006. Ten randomly chosen controls were matched to each case on age, gender, and calendar date. Results-During the study period 1004 incident cases of SAH were identified. Current use of statins did not significantly decrease the risk of SAH (OR = 0.77, 95% CI 0.55 to 1.07). The odds ratio for recent withdrawal compared to nonusers was 1.62 (95% CI 0.96 to 2.73). Compared to current use, recent withdrawal was associated with an increased risk of SAH (OR = 2.34, 95% CI 1.35 to 4.05). Interaction analysis showed that the effect of statin withdrawal was highest in patients who had also recently stopped antihypertensive drugs (OR = 6.77, 95% CI 2.10 to 21.8). Conclusions-Current use of statins seems to lower the risk of SAH, although the reduction was not significant in new users. Statin withdrawal increased the risk of SAH by a factor 2, even more in patients who had also recently stopped their antihypertensive treatment. (Stroke. 2009; 40: 2887-2892.)
U2 - 10.1161/STROKEAHA.109.552760
DO - 10.1161/STROKEAHA.109.552760
M3 - Article
SN - 0039-2499
VL - 40
SP - 2887
EP - 2892
JO - Stroke
JF - Stroke
IS - 8
ER -