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Updated: Aug 6, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Achieving target cholesterol goals after stroke: is in-hospital statin initiation the key?
Nerses Sanossian1, Jeffrey L Saver, David S Liebeskind
1Stroke Center and Department of Neurology, Olive View Medical Center, University of California-Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095, USA. nsanossian@mednet.ucla.edu
Insights
Initiating statin therapy during hospitalization for ischemic stroke significantly improves patient adherence to treatment and helps achieve cholesterol goals. This approach is vital for secondary vascular disease prevention.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- National guidelines recommend statin therapy for secondary prevention in atherosclerotic ischemic stroke or transient ischemic attack.
- Statins are proven beneficial for individuals at high risk of vascular disease.
Purpose of the Study:
- To assess the impact of initiating statin therapy during hospitalization on 3-month adherence rates.
- To determine if in-hospital statin initiation helps achieve national cholesterol target goals.
Main Methods:
- Consecutive patients admitted with ischemic stroke or transient ischemic attack between September 2002 and April 2005 were analyzed.
- Patients not on statins pre-admission but with a clear indication were included.
- Statin adherence and cholesterol levels were evaluated at 3 months post-discharge.
Main Results:
- Hospital initiation of statins resulted in 93% adherence at 3 months.
- Mean low-density lipoprotein cholesterol decreased from 120 mg/dL to 78 mg/dL (P<.001).
- The proportion of patients achieving <100 mg/dL low-density lipoprotein cholesterol increased from 36% to 88% (P<.001).
Conclusions:
- Initiating statin therapy during hospitalization for ischemic cerebrovascular events leads to high adherence.
- This strategy effectively lowers low-density lipoprotein cholesterol levels.
- In-hospital statin initiation increases the likelihood of meeting national cholesterol guidelines.
Background:
National advisories recommend statin therapy as an element of secondary prevention for patients with ischemic stroke or transient ischemic attack of atherosclerotic origin. Statins are of proven benefit in persons at high risk of vascular disease.
Objectives:
To evaluate the effects of in-hospital initiation of statins on 3-month treatment adherence rates and achievement of national guideline target cholesterol goals.
Methods:
Data were collected in consecutively encountered patients with ischemic stroke or transient ischemic attack admitted to a university hospital stroke service beginning September 1, 2002. Patients were included in the study if they were not receiving a statin before admission and had an indication for statin therapy. Adherence to statin treatment and achievement of national guideline target cholesterol goals were assessed 3 months after discharge.
Results:
From September 1, 2002, through April 30, 2005, 92 (17%) of 552 individuals met the study criteria. Hospital initiation of statin therapy yielded high rates of adherence (93% [86/92]), lowered mean low-density lipoprotein cholesterol levels from 120 to 78 mg/dL (3.1 to 2.0 mmol/L; P<.001), and increased the proportion of patients with low-density lipoprotein cholesterol levels lower than 100 mg/dL (2.6 mmol/L) from 36% to 88% (P<.001) at 3 months.
Conclusions:
Statin initiation during hospitalization for an ischemic cerebrovascular event is associated with high rates of adherence to treatment, lowering of low-density lipoprotein cholesterol levels, and higher rates of achieving national cholesterol guidelines.
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