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Recent Nationwide Trends in Discharge Statin Treatment of Hospitalized Patients With Stroke

Background and Purpose— The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial showed statins reduce vascular risk among patients with atherosclerotic stroke or transient ischemic attack. In this study, we assessed recent nationwide trends in discharge statin treatment after acute stroke and the influence of SPARCL on clinical practice. Methods— Using data from eligible patients with stroke and transient ischemic attack admitted to Get With The Guidelines–Stroke (GWTG-Stroke) -participating hospitals between January 1, 2005, and December 31, 2007, we assessed discharge statin use over time and in relation to dissemination of the SPARCL results. Results— Among 173 284 patients with ischemic stroke and transient ischemic attack, overall discharge statin treatment was 83.5%. Discharge statin prescription climbed steadily but modestly over the 2-year study period from 75.7% to 84.8% (P<0.001) with a nonsignificant increase during SPARCL reporting but a return to prior levels thereafter. Factors associated with lower discharge statin use in patients without contraindications included female sex and South region. Conclusions— Discharge statin prescription among hospitalized patients with stroke increased over time, but 1 in 5 patients still leaves the hospital without treatment. Primary drivers of increased use were secular trends and individual/hospital site characteristics.