Association between statin use and post-ischemic stroke epilepsy among older adults: A nested case-control study

Area of Science:

• Neurology
• Cardiology
• Pharmacology

Background:

• Post-stroke epilepsy (PSE) is a significant complication following ischemic stroke.
• Statin therapy is commonly prescribed after ischemic stroke for cardiovascular risk reduction.
• The association between statin use and PSE risk, and potential sex-based differences, requires clarification.

Purpose of the Study:

• To estimate the association between post-stroke statin use and the risk of developing PSE.
• To assess whether biological sex modifies the relationship between statin use and PSE.
• To investigate the impact of specific statin characteristics and other risk factors on PSE.

Main Methods:

• Population-based nested case-control study utilizing linked health administrative data in Ontario, Canada.
• Inclusion of residents aged over 65 treated for ischemic stroke between April 2007 and March 2017.
• Matching of epilepsy cases (n=1009) with up to 10 controls (n=6522) on age, sex, and month; multivariable conditional logistic regression analysis.

Main Results:

• Overall statin use was not significantly associated with an increased risk of PSE (IRR = 1.17; 95% CI 0.95-1.43).
• Sex did not significantly modify the association between statin use and PSE (p=0.08).
• Atorvastatin use was associated with an increased risk of PSE specifically among females (IRR = 1.26; 95% CI 1.02-1.56).

Conclusions:

• Post-stroke statin use, in general, does not appear to increase the risk of developing epilepsy.
• While sex did not modify the overall association, atorvastatin use warrants further investigation due to a potential increased PSE risk in women.
• Further research is needed to elucidate the specific mechanisms underlying the observed association between atorvastatin and PSE in females.