Effect of In-Hospital Initiation of Lipid-Lowering Therapy on Six-Month Outcomes in Patients With Acute Ischemic Stroke or Transient Ischemic Attack

Early lipid-lowering therapy (LLT) has demonstrated clinical benefits in patients with acute coronary syndrome; however, little is known about early LLT in patients with stroke. We evaluated the effect of in-hospital initiation of LLT on the clinical outcomes of patients with stroke. The Taiwan Stroke Registry prospectively collected data from patients with acute ischemic stroke or transient ischemic attack. By July 31, 2008, 16,704 adult patients without previous LLT had been admitted and survived to discharge. The study end point was the composite outcome of recurrent stroke, ischemic heart disease, and all-cause death. We examined the effect of LLT at discharge on the clinical outcomes of these patients. A propensity analysis was done to adjust for selection biases in the prescription of LLT. At discharge, 4,032 patients (24%) had received LLT. At 6 months, 206 patients (5.1%) in the LLT group and 964 patients (7.6%) in the non-LLT group had developed ≥1 component of the composite end point (p