Study Suggests Strokes May be Treated Differently than Heart Attacks

Of patients studied, only one-third of those who had had a stroke were receiving guideline-recommended statin therapy, while nearly a quarter of these patients were not receiving any statins.

A recent study from DCRI researchers found that patients who have had strokes may receive different care than those who have had heart attacks, despite evidence that shows statins are effective for secondary prevention in both populations to prevent recurring ischemic events.

The study, which was led by DCRI’s Ying Xian, PhD, (pictured), compared three groups of patients: those with coronary artery disease (heart attack), those with cerebrovascular disease (stroke), and those with both conditions. The group’s analysis, which was published in the Journal of the American Heart Association, included 3,232 patients from 133 sites within the Patient and Provider Assessment of Lipid Management (PALM) Registry. Using this data source enabled investigators to examine both patient perceptions of statins, along with actual use of the therapy.

Among the three patient groups, investigators found no difference in their perceptions about future cardiovascular risk or effectiveness of statins. However, patients who had a stroke were less likely to receive statins (76.2 percent, versus 86.2 percent of those who had heart attacks), as well as less likely to receive statin therapy at guideline-recommended intensity (34.6 percent, versus 50.4 percent of those who had heart attacks).

No significant differences were found between the group of patients who had a heart attack and the group who had both a heart attack and a stroke.

“Only one-third of patients who had had a stroke were receiving guideline-recommended statin therapy,” Xian said. “Because we found no evidence that a difference in patient perception is contributing to this gap, these findings suggest that providers can do more to ensure their stroke patients receive therapy at target levels.”

Other DCRI contributors to this study include Ann Marie Navar, MD, PhD; Eric Peterson, MD, MPH; and Tracy Wang, MD, MHS, MSc.

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