Abstract Details

Title Primary Prevention of Ischemic Stroke with Aspirin or Statins for Patients with Fibromuscular Dysplasia: A Retrospective Case-control Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-001

Objective

This study aims to assess the efficacy of aspirin and statin use in the primary prevention of stroke for patients with fibromuscular dysplasia (FMD).

Background FMD is a non-atherosclerotic, non-inflammatory vasculopathy associated with cerebrovascular complications. Primary prevention of stroke in patients with FMD remains controversial despite consensus guidelines recommending daily aspirin.

Design/Methods This retrospective case-control study identified adults with FMD using a de-identified, aggregate medical record database at a single medical center. Exclusions included diagnoses of malignancy, thrombophilia, connective tissue disease, prior myocardial infarction, or stroke before FMD diagnosis. The outcome of interest was ischemic stroke, while variables of interest were antecedent aspirin or statin use. Multivariable logistic regression was conducted, controlling for age and sex, to determine odds ratios (ORs) and associated 95% confidence intervals.

Results Of 1053 eligible patients with FMD, 806 (76.5%) were on aspirin, and 593 (56.3%) on statins. Ischemic stroke followed FMD diagnosis in 30 (2.8%) patients. Aspirin use was associated with decreased odds of ischemic stroke (OR: 0.33 [0.17-0.70], p-value: 0.004), with patients aged 60-69 years having the lowest odds (OR: 0.095 [0.02-0.55], p-value: 0.009), and women (OR: 0.40 [0.02-0.87], p-value: 0.021) having higher odds than men (0.061 [0.005-0.825], p-value: 0.035). Statin use was not associated with decreased odds of stroke (OR: 0.55 [0.28-1.17], p-value: 0.118).

Conclusions Aspirin use was associated with significantly decreased odds of incident ischemic stroke in adults with FMD, supporting consensus guidelines. Statin use was not associated with changes in stroke odds. Further investigation is underway, including adjudication of stroke outcomes and external validation within the North American Registry for FMD.

Authors/Disclosures
David DiMeglio PRESENTER	Mr. DiMeglio has nothing to disclose.
Thoai Vu, MD	Dr. Vu has nothing to disclose.
Randy K. Ramcharitar, MD	Dr. Ramcharitar has nothing to disclose.
Andrew M. Southerland, MD, FAAN (University of Virginia, Dept of Neurology)	Dr. Southerland has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Plaintiffs and Defense Cases related to Stroke and Vascular Neurology.. The institution of Dr. Southerland has received research support from American Heart Association. The institution of Dr. Southerland has received research support from NIH. The institution of Dr. Southerland has received research support from Abbvie Pharmaceuticals, Inc.. Dr. Southerland has received intellectual property interests from a discovery or technology relating to health care. Dr. Southerland has received intellectual property interests from a discovery or technology relating to health care.

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