LAUSR

Introduction: Statins are recommended in national guidelines for secondary prevention following acute ischemic stroke (AIS). Studies have reported patients not taking statins after AIS have increased mortality. The purpose of this retrospective quality improvement initiative was to determine if there is a difference in prescription of statin medications at discharge for patients with AIS within a Stroke Clinical Network (SCN), consisting of one comprehensive stroke center (CSC) and eight primary stroke centers (PSC). Methods: The Get with The Guidelines registry was queried for AIS patients admitted to the SCN between 2017-2022 to evaluate discharge practices for statins. Information was collected to include age, gender, race, history of CAD, DM, HTN, and if discharging facility was a PSC or a CSC. Patients were excluded if they died, discharged to hospice, or if a reason for no statin at discharge was documented. A Chi-square and a multivariable regression were performed to examine the relationships between demographic and medical variables and if a statin was prescribed at discharge. Results: A total of 15,606 AIS patients were identified. Mean age was 68 years (SD +/- 14.2), 50% male (7798/15606), and 38.8% Black (6061/15606). Of the 15,606, a total of 13,319 (85.3%) were prescribed a statin at discharge. Compared to patients with the following risk factors, there was a significant difference in the odds of being discharged without a statin for patients who did not have HTN (OR 1.52, 95% CI [1.36-1.69]), DM (OR 1.65, 95% CI [1.48-1.83]) or CAD (OR 1.34, 95% [1.18-1.53]). Patients who are < 70, white, female, and discharged from a PSC are also at higher risk for non-statin use. Conclusions: In a large SCN, those without well-known vascular risk factors, those under the age of 70, white patients and women were at higher risk of not being prescribed statins at discharge. Further studies should be done to address these disparities and to optimize secondary stroke prevention.