HMG-CoA Reductase Inhibitor (Statin) Prescribing for Ischemic Stroke Patients at Hospital Discharge

Objective: To examine practices in statin prescribing at discharge in ischemic stroke patients, and to evaluate racial differences in prescribing. Background: The most recent ACC/AHA cholesterol guidelines recommend statin use in four groups of individuals. Methods: We analyzed consecutive ischemic strokes admitted to our CSC from 1/2011-2/2015. Patient characteristics, comorbidities, and medication use were collected. Among the 1,022 strokes, analysis was restricted to patients with a statin indication who were not taking a statin prior to admission (n=436). Associations between statin indication group and discharge statin prescribing were quantified using modified Poisson regression models. Race was evaluated as a potential confounder and/or effect modifier. Results: Our sample had a median age of 63 (IQR 55, 73) with 54[percnt] men and 71[percnt] black. Over 91[percnt] of patients were discharged on a statin (whites 92[percnt], blacks 91[percnt]). Among the treatment groups, we observed 397 individuals with clinical atherosclerotic cardiovascular disease (ASCVD; group 1), 32 with diabetes aged 40-75 with LDL-cholesterol 70-189 without ASCVD (group 3), and 16 without ASCVD or diabetes with LDL-cholesterol 70-189 and a 10-year ASCVD risk u003e7.5[percnt] (group 4). Race was not a confounder in the association between statin indication group and discharge prescribing, but was found to be an effect modifier among patients with clinical ASCVD (data will be presented). When compared to blacks, whites in group 3 were more likely to have a statin prescribed at discharge (RR 1.10, 95[percnt] CI 1.01-1.20) even after adjustment for age, liver disease, and LDL. Conclusions: Our observations suggest that neurologists may be more likely to prescribe a statin at the time of discharge for whites in group 3 (diabetics age 40-75 with LDL 70-189 without ASCVD) when compared to their black counterparts. Further research is needed to determine if racial disparities exist in discharge statin prescribing for stroke survivors. Disclosure: Dr. Albright has nothing to disclose. Dr. Vahidy has nothing to disclose. Dr. Sisson has nothing to disclose. Dr. Samai has nothing to disclose. Dr. Schluter has nothing to disclose. Dr. Martin-Schild has received personal compensation for activities with Genentech.