EClinicalMedicine

Statin initiation after ischemic stroke or TIA: Atorvastatin vs. rosuvastatin

August 5, 2025

Study details: This national registry-based observational study analyzed 3,322 adults with ischemic stroke or TIA (pre-stroke modified Rankin Scale [mRS], 0) from the Third China National Stroke Registry, all of whom initiated either atorvastatin or rosuvastatin on the day of symptom onset. Primary outcome was an mRS score of 0 at 3 months. Secondary outcomes included ideal outcome at discharge, 6 and 12 months, as well as 12-month stroke recurrence, all-cause mortality, CV mortality, and major adverse CV events.

Results:A higher proportion of rosuvastatin vs. atorvastatin initiators achieved mRS 0 at 3 months (44.6% vs. 41.5%; relative rate, 1.12; 95% confidence interval, 1.03–1.22). Rosuvastatin was also associated with higher rates of ideal outcome at discharge and 6 months. No significant differences were observed in stroke recurrence, mortality, or major adverse CV events at 12 months.

Clinical impact: While rosuvastatin may confer a modest short-term functional advantage, the absolute differences are small and don’t translate into differences in major vascular outcomes. Authors call for further research to validate the findings and determine if rosuvastatin should be preferentially prescribed over atorvastatin for post-stroke patients.

Source:

Zhao J, et al. (2025, July 24). EClinicalMedicine. Comparative effectiveness and safety of atorvastatin versus rosuvastatin among patients with ischemic stroke or transient ischemic attack: a national registry-based observational study. https://pubmed.ncbi.nlm.nih.gov/40747367/