Risk Factors Associated with Increased Risk of First Ischemic Stroke in Dyslipidemic Patients undergoing Simvastatin Treatment in Primary Healthcare Settings
Risk Factors Associated with Increased Risk of First Ischemic Stroke in Dyslipidemic Patients
Keywords:
dyslipidemia, ischemic stroke, primary prevention, simvastatinAbstract
Primary prevention of cardiovascular disease with statins in patients with dyslipidemia reduces the risk of new ischemic stroke. However, some patients on statin therapy still develop ischemic stroke. This retrospective study aimed to assess risk factors that increase the chance of the first ischemic stroke in dyslipidemic patients with receiving simvastatin at primary care unit, Buddhachinaraj Phitsanulok Hospital and developed first ischemic stroke between January 1, 2019 and December 31, 2023. The study included 67 dyslipidemic patients and control group of 134 dyslipidemic patients without ischemic stroke. The control group was matched by the same date of the last simvastatin prescription in the study group before onset of ischemic stroke. A case to control ratio of 1: 2 was applied. Multivariable logistic regression analysis of the predictive factors revealed that patients with dyslipidemia treated with simvastatin had risk factors for the first ischemic stroke as follows: hypertension (aOR 4.97; 95% CI: 1.44-17.15), smoking (aOR 3.60; 95% CI: 1.08-11.93), discontinue follow up (aOR 2.13; 95% CI: 0.90-5.04), total cholesterol ≥ 200 mg/dL (aOR 2.31; 95% CI: 1.03-5.18), and glomerular filtration rate 15-29 ml/min/1.73 sq.m. (aOR 24.67; 95% CI: 2.28-267.08). Therefore, guidelines for surveillance, health promotion, and disease prevention in this group of patients should be developed more comprehensively
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