In the Comprehensive Post-Acute Stroke Services (COMPASS) Study, statin prescribing remains lower among White patients, in those with transient ischemic attack (TIA), and in those residing in nonurban areas, researchers report. Intensive statin therapy was also limited, particularly among those aged 75 years or older.
At 27 participating hospitals, medications taken before hospitalization and those prescribed on discharge among patients with stroke or TIAs were compared by age (<65, 65–75, >75 years), racial category (White vs. Black), sex (male vs. female), and rurality (urban vs. nonurban), and for statin and intensive statin prescribing. “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,” the authors report. “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.”
“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.”