statins

morbidity/mortality

statin discontinuation

Internal Medicine and Geriatrics

Vascular Surgery

Angiology

Besides lipid lowering and the management of hyperlipidemias, statins exert several non-lipid (so-called “pleiotropic”) actions. It has been demonstrated that statin withdrawal increases the risk of subarachnoidal hemorrhage, as well as mortality rates after an ischemic stroke episode. Statin withdrawal at the time of admission for a hemispheric ischemic stroke is also associated with an almost 20-fold increase in the risk of early neurologic deterioration compared with previous statin non-use. A recent report underlines the increased incidence of intracranial hemorrhage associated with high statin dosage use in patients with a prior history of stroke. This was not verified by an independent report. Physicians should make sure that once initiated, statin treatment is not interrupted except for a very good reason (e.g. intracerebral hemorrhage) in order to avoid the occurrence of a first or a recurrent vascular event.