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- W2189192604 abstract "Context: Statins are widely prescribed for primary and secondary prevention of ischemic cardiac and cerebrovasculardisease.Althoughseriousadverseeffectsareuncommon,resultsfromarecentclinicaltrialsuggestedincreasedriskofintracerebralhemorrhage(ICH)associated with statin use. For patients with baseline elevated risk of ICH, it is not known whether this potential adverse effect offsets the cardiovascular and cerebrovascular benefits. Objective: To address the following clinical question: Given a history of prior ICH, should statin therapy be avoided? Design: A Markov decision model was used to evaluate the risks and benefits of statin therapy in patients with prior ICH. Main Outcome Measure: Life expectancy, measured as quality-adjusted life-years. We investigated how statin use affects this outcome measure while varying a range of clinical parameters, including hemorrhage location (deep vs lobar), ischemic cardiac and cerebrovascular risks, and magnitude of ICH risk associated with statins. Results: Avoiding statins was favored over a wide range ofvaluesformanyclinicalparameters,particularlyinsurvivorsoflobarICHwhoareathighestriskofICHrecurrence. InsurvivorsoflobarICHwithoutpriorcardiovascularevents, avoidingstatinsyieldedalifeexpectancygainof2.2qualityadjustedlife-yearscomparedwithstatinuse.Thisnetbenefit persisted even at the lower 95% confidence interval of the relative risk of statin-associated ICH. In patients with lobarICHwhohadpriorcardiovascularevents,theannual recurrenceriskofmyocardialinfarctionwouldhavetoexceed90%tofavorstatintherapy.Avoidingstatintherapywas alsofavored,althoughbyasmallermargin,inbothprimary andsecondarypreventionsettingsforsurvivorsofdeepICH. Conclusions:Avoiding statins should be considered for patients with a history of ICH, particularly those cases with a lobar location." @default.
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- W2189192604 date "2011-01-01" @default.
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- W2189192604 title "Statin Use Following Intracerebral Hemorrhage" @default.
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