Chung Chang-Min,Lin Ming-Shyan,Liu Chi-Hung,Lee Tsong-Hai,Chang Shih-Tai,Yang Teng-Yao,Pan Kuo-Li,Lin Yu-Sheng, Discontinuing or continuing statin following intracerebral hemorrhage from the view of a national cohort study, Atherosclerosis, Volume 278, 2018, Pages 15-22.
PubMed link: https://www.ncbi.nlm.nih.gov/pubmed/30236866
| Methods | Study design: Retrospective case control study
Number of groups: 2 |
| Participants | Number of participants: 2468
Active group: 813 Control: 1655 Age: Mean 67 (± 11.6) Sex: 1299 female (52%) Participants with dementia: 89 Inclusion criteria: · Admission diagnosis intracerebral haemorrhage (ICD-9-CM: 431) · Statin use within the previous 3 months 18-100 years of age Exclusion criteria: Administration of non-statin lipid lowering agents within 3 months prior Death or other loss to follow up within 3 months of haemorrhage Cerebrovascular accident within 3 months of haemorrhage Country: Taiwan Setting: Hospital |
| Interventions | Medicine: Statins
Withdrawal schedule: Not described Comparator: Continued statin therapy |
| Outcomes | All-cause mortality
Cerebrovascular outcomes (ischemic stroke, recurrent ICH) New onset diabetes, dementia, atrial fibrillation, malignancy, acute hepatitis, rhabdomyolysis, pancreatitis |
| Dates | Dates: 01 Jan 2001-31 Dec 2013
Follow-up duration: 36 months |
| Funding sources | Chang Gung Memorial Hospital research grant |
| Notes |
Risk of bias table
| Bias | Authors’ judgment | Support for judgment |
| Random sequence generation (selection bias) | Low | Study design |
| Allocation concealment (selection bias) | Low | Study design |
| Blinding of participants and personnel (performance bias) | Low | Retrospective study |
| Blinding of outcome assessment (detection bias) | High | Assessors not blinded |
| Incomplete outcome data (attrition bias) | Low | Epidemiological study, used propensity matching for missing data |
| Selective reporting (reporting bias) | Low | Study protocol with pre-specified outcomes |
| Confounding (non-randomized) | Low | Attempted to match participants with propensity score matching. Multiple confounders reported and included in analysis |
| Other bias | ||
| Selection bias | Representativeness of the exposed cohort | A: truly representative of the average statin-user post-ICH |
| Selection of the non-exposed cohort | B: drawn from the same cohort | |
| Ascertainment of exposure | A: secure record | |
| Demonstration that outcome of interest was not present at start of study | A: Yes | |
| Comparability bias | Comparability of cohorts on the basis of the design or analysis | A: Study controls for statin exposure |
| Outcome bias | Assessment of outcome | B: record linkage |
| Was follow-up long enough for outcomes to occur | A: yes | |
| Adequacy of follow-up of cohorts | A: complete follow-up | |
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