Despite recommendations for high-intensity statins following ischemic strokes or transient ischemic attacks (TIAs), data from the Comprehensive Post-Acute Stroke Services (COMPASS) Study show disparate prescribing statins on discharge after hospitalizations for these conditions based on age, race, and sex. “These findings appear inconsistent with currently available guidelines regarding post-stroke statin prescribing, and additional research is needed to understand the context for such differences,” the authors conclude. “Additional prospective trials are also needed in patients over 75 years of age to clarify the potential benefit of statins in this age group, which may be at higher risk for adverse effects and medication non-adherence.”
At 27 participating N.C. hospitals, medications being taken before hospitalization and statins prescribed at discharge were compared by age (<65, 65–75, >75 years), racial category (White vs. Black), sex (male vs. female), and rurality (urban vs. nonurban). “Among 3,211 patients (mean age 67 years; 47% female; 29% Black), 90% and 55%, respectively, were prescribed any statin or intensive statin therapy at discharge,” write the authors. “White (vs. Black) patients (0.71, 0.51–0.98) less commonly received any statin prescription, while stroke (vs. TIA) patients (1.90, 1.38–2.62) and those residing in urban areas (1.66, 1.07–2.55) more commonly received any statin prescription. Among those prescribed a statin, only 42% of White and 51% of Black patients >75 years were prescribed an intensive statin; the OR for intensive statin prescribing was 0.44 for patients >75 years and was similar in a subgroup not on a statin previously.”