Statin overuse in acute cerebral ischaemia linked to thousands of AEs per year

More than one-fifth of patients with acute cerebral ischaemia (ACI) appear to be receiving statins unnecessarily, which has the potential to cause higher than 5,600 adverse events (AEs) each year, including diabetes, myopathy, and eye disease, according to the results of a meta-analysis.

Researchers searched multiple online databases for randomized clinical trials of statins to determine absolute risk increases for major adverse events, as well as large clinical series to determine the proportion of ACI events due to large or small vessel atherosclerotic disease and the proportion of remaining patients with coronary artery disease/primary prevention statin indications.

A total of 63 randomized clinical trials, which involved 155,107 ACI patients, were included in the meta-analysis for adverse effects. Pooled data showed that statin therapy was associated with an increased risk of the following conditions occurring: diabetes, myalgia or muscle weakness, myopathy, liver disease, renal insufficiency, and eye disease.

Meanwhile, according to synthesized data from 55 large series that involved 53,501 patients, the rate of ACI due to large and small artery atherosclerosis was 45.0 percent (large artery atherosclerosis 21.6 percent, small vessel disease 23.4 percent). Of the remaining patients with coronary artery disease, 31.8 percent had primary prevention statin indications while 23.2 percent had no such indications.

In the United States, if all ACI patients without statin indications received the drug, more than 5,600 would have unnecessary side effects annually, most commonly diabetes, myopathy, and eye disease.

The present data underscore the importance of adhering to guideline indications for the start of statin therapy in ACI.