It remains unclear whether
statin therapy should be applied to
ischemic stroke patients with
atrial fibrillation. The objective of this study was to clarify whether
statin therapy can influence the prognosis in recent
ischemic stroke patients with
atrial fibrillation.We identified
ischemic stroke patients with
atrial fibrillation between 2001 and 2011 from Taiwan National Health Insurance Database. Patients not treated with
statins during the first 90 days after the index
stroke were matched to patients treated with
statins in the first 90 days in a 2:1 ratio on the basis of age, sex,
hypertension,
diabetes mellitus,
ischemic heart disease,
heart failure, estimated National Institutes of Health
Stroke Scale, use of
anticoagulant, and year of their entry into the cohort. The primary outcome was the first event of recurrent
stroke, and the secondary outcome was in-hospital death.A total of 1546
atrial fibrillation patients with
statin therapy in the first 90 days poststroke and 3092 matched
atrial fibrillation nonstatin controls were enrolled for this analysis. During the median 2.4-year follow-up, the risk of recurrent
stroke was not different between subjects receiving versus not receiving
statin therapy (hazard ratios = 1.01, 95% confidence interval 0.88 to 1.15). However, patients with
atrial fibrillation receiving
statin therapy had a reduced risk for death during any hospitalization throughout the long-term follow-up period (hazard ratios = 0.74, 95% confidence interval 0.61 to 0.89).Among
ischemic stroke patients with
atrial fibrillation,
statin therapy initiated during the acute to subacute poststroke stage did not alter the rate of
stroke recurrence but was associated with a decreased rate of in-hospital death.