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Statins May Be Harmful After Stroke
Date:1/10/2011

ate patient's conditions to show combinations of events that could lead to the increased risk of stroke or heart disease, change in quality of life, or death.

The results of their study indicated that patients taking statins had a 14 percent to 22 percent greater risk of having another hemorrhagic stroke, particularly patients whose stroke was a lobar intracerebral hemorrhage, or bleeding in the part of the brain called the cerebrum.

For these patients, the risk of taking a statin outweighed any benefit from the drug, the researchers found.

"However, the last word isn't in on how consistently statins increase the risk for a second hemorrhagic stroke," Greenberg said. "But there is at least enough now to make it something to be discussed between patient and doctor."

For patients whose bleeding occurred deep within the brain, the benefit versus the risk of statins was more balanced, they noted. This suggests that whether or not to prescribe a statin after hemorrhagic stroke may depend on the location of the stroke in the brain.

Why statins might increase the risk of hemorrhagic stroke is unknown, Westover said. It may be due to an increased risk of brain bleeding among people with low cholesterol, or perhaps statins prevent clotting, he said.

Greenberg noted that the use of statins to prevent a second ischemic stroke, one caused by a clot in a blood vessel in the brain, is standard care and has been shown to be effective.

Dr. Larry B. Goldstein, director of the Duke Stroke Center and author of an accompanying journal editorial, said the current data on the use of statins after a hemorrhagic stroke is limited but he generally supports this latest finding.

Dr. Ralph L. Sacco, president of the American Heart Association and chairman of neurology at the University of Miami Miller School of Medicine, said that the recent guidelines from the American Heart Association recommend statins after ischemic stroke.

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