Abstract 91: Early Stroke Recurrence Is Not Reduced By Early Statin Initiation In The Point Trial Population

Objective: To discern effects of early statin treatment on early stroke recurrence in the POINT trial. Background: Benefits of statin therapy in reducing risk of ischemic stroke over the long-term are well-established, but the immediate effects of statin therapy on early stroke recurrence after an initial ischemic event are less clear. Design/Methods: In secondary analysis of the data of the Platelet Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial, we evaluated the effects of statins on early stroke recurrence within 7 days of randomization using Cox proportional hazard regression analysis. We separately compared the effects in subgroups of subjects on and not on statins prior to the index event. Results: In the POINT trial, most recurrences of ischemic stroke were early, with 175 occurring within 7 days of trial entry, and only 105 occurring over the remainder of the 90 day trial. Overall, 39% were on statin treatment at time of enrollment which increased to 79% by 7 days post-index event. In Cox proportional hazard analysis for stroke recurrence over the 7 day period after index stroke or TIA, statin administration showed no significant effect in subjects not on statin at baseline (Adjusted p=0.34). In contrast, statin use prior to enrollment was associated with decreased hazard of early stroke recurrence (Adjusted H.R. 0.31, p=0.001). Conclusion: In the POINT trial population of patients with minor ischemic stroke or TIA, prior treatment with statins was associated with decreased risk of early stroke recurrence within 7 days following index stroke or TIA. There was no effect of initiating statin treatment in reducing risk of early stroke recurrence.