No increased cardiovascular risk for women discontinuing statins at pregnancy

Discontinuation of statins at pregnancy does not appear to contribute to increased cardiovascular (CV) risk for expectant mothers, including those at high CV risk, according to a study.

Researchers used data from the National Health Insurance Database of South Korea. They identified women who used statins for 12–24 weeks before their last menstrual period.

Maternal cardiovascular outcomes were assessed, including major adverse cardiovascular and cerebrovascular events (MACCE), a composite of myocardial infarction, stroke, coronary revascularization, and cardiovascular death. Gestational and foetal outcomes such as preterm delivery, pre-eclampsia/eclampsia, other hypertensive disorders of pregnancy, gestational diabetes, nonlive birth, major congenital malformations, and low birth weight were also evaluated.

A total of 13,374 women with preconception statin use were included in the analysis. Of these, 5,881 (44 percent) discontinued statin therapy before their last menstrual period, while 7,493 (56 percent) continued taking statins.

The risk of maternal MACCE did not differ between women who discontinued and those who continued statin therapy beyond their last menstrual period (hazard ratio [HR], 1.00, 95 percent confidence interval [CI], 0.72–1.37). This held true in the subgroup of women with established familial hypercholesterolemia (n=2,435; HR, 0.92, 95 percent CI, 0.46–1.85) and those with atherosclerotic cardiovascular disease (n=1,879; HR, 0.83, 95 percent CI, 0.46–1.49).

Notably, statin discontinuation was associated with reduced risks of nonlive birth (risk ratio [RR], 0.89, 95 percent CI, 0.82–0.95) and low birth weight (RR, 0.88, 95 percent CI, 0.78–0.99).