Background/Purpose: Statins are essential in preventing stroke recurrence by atherosclerotic plaque accumulation, which can trigger acute ischemic strokes (AIS) when disrupted. Based on the differences in the pharmacokinetic profiles of atorvastatin and rosuvastatin, it is unclear if one agent is more effective at reducing the rates of stroke recurrence in adult survivors of AIS. The purpose of this study is to evaluate the rates of stroke recurrence in AIS patients receiving high-intensity statin therapy (HIST) with rosuvastatin or atorvastatin.
Methods: In this retrospective cohort study adult patients with a diagnosis of AIS and discharged with HIST were screened if admitted from July 1, 2016, to October 31, 2020. High-intensity statin use was determined by having atorvastatin 40-80 milligrams daily or rosuvastatin 20-40 milligrams daily on the patient’s discharge medication list. The primary outcome of this study was rates of stroke recurrence within five years. Secondary outcomes evaluated were stroke recurrence within twenty-one days, stroke recurrence within one year, and rates of statin discontinuation within five years.
Results: 5-year stroke recurrence from the initial AIS found that 10 (12.5%) of the atorvastatin and 6 (15%) of the rosuvastatin patients had an episode of stroke recurrence (OR 1.235; 95% CI, 0.415-3.681; p = 0.778). Similar to the primary outcomes, none of the secondary outcomes were statistically significant.
Conclusions: Our results support either statin would be efficacious for secondary prevention, though there is an increased risk of myopathy associated with lipophilic statins (i.e., atorvastatin). Due to our studies' small sample size, it would be advantageous for future research to utilize a larger sample size to determine a potential clinical difference.
