Background and Purpose- Knowledge of the use of secondary preventive medication in young adults is limited. We studied the use of
statins and its association with subsequent vascular events in young adults with
ischemic stroke-a patient group with a known low burden of
atherosclerosis. Methods- The study population included 935 first-ever 30-day
ischemic stroke survivors aged 15 to 49 years from the Helsinki Young
Stroke Registry, 1994 to 2007. Follow-up data until 2012 were obtained from the Social Insurance Institution of Finland (
Drug Prescription Register), the Finnish Care Register, and Statistics Finland. The association of the use of
statins (defined as at least 2 purchases) with all-cause mortality, recurrent
stroke, and other recurrent vascular events was assessed through adjusted Cox regression analyses. We further compared propensity score-matched
statin users with nonusers. Results- Of our 935 patients, 46.8% used
statins at some point during follow-up. Higher age,
dyslipidemia, heavy alcohol use, and
hypertension were significantly associated with purchasing
statins.
Statin users exhibited lower risk of all-cause mortality (hazard ratio, 0.38 [95% CI, 0.25-0.58]) and recurrent
stroke (hazard ratio, 0.29 [95% CI, 0.19-0.44]) than nonusers, after adjustment for
dyslipidemia,
stroke subtype, and other confounders. These results remained unchanged after propensity score-matched comparison. Conclusions- Less than half of young
ischemic stroke patients used
statins; use was affected by age and risk factor profile.
Statin use was independently associated with lower risk of all-cause mortality and recurrent
stroke.