Stroke in Young Adults: Are Statins the Answer?

Mark J. Alberts, MD


September 23, 2011

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Hello, and welcome to this Medscape stroke blog. I am Dr. Mark Alberts, Professor of Neurology and Director of the Stroke Program at Northwestern University in Chicago, Illinois.

Today I would like to talk about a small but intriguing study,[1] published in the August 5th edition of the journal Neurology that looked at 1008 young adults, ages 18-45, who had suffered a stroke. After extensive work-ups, 215 of the 1008 patients were found to have stroke of unknown etiology. Of those 215 patients, about one third received a statin agent, and two thirds did not. The investigators' hypothesis seemed to be that in young people with stroke of unknown etiology, the use of a statin agent would have an effect on the risk for recurrent stroke. In their analysis, they controlled for variables such as age, lipids, and other stroke risk factors.

The results were quite intriguing. What they found at the end of the study was that, after adjusting for all of these other factors, those patients who took a statin agent had a much lower risk of having a recurrent stroke than patients who never took a statin agent. Furthermore, patients who took a statin agent intermittently, or discontinuously, in the follow-up had an intermediate risk of having a stroke. Again, this was after controlling for all of the traditional stroke risk factors.

Even though this study was relatively small, it answers an intriguing but important question. Should we be using statin agents for young adults who have had an ischemic stroke of unknown etiology? This small study would seem to suggest that the answer is yes. These agents appear to be safe and effective, even in relatively young people who, after an extensive work-up, are found to have strokes of unknown etiology.

Certainly, more work needs to be done with larger studies, and larger populations, and it is important to note that this was not a prospective randomized trial. Yet, the results are interesting and intriguing, and perhaps begin to answer an important clinical question about how best to treat these folks, particularly young adults with stroke of unknown etiology. Statins may be the way to go. Thank you for your attention. Have a good day.


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