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Statin therapy and stroke prevention: what was known, what is new and what is next?

Abstract

PURPOSE OF REVIEW

Randomized trials have shown that statins may reduce the risk of primary stroke. There is no evidence however that statins can reduce recurrent stroke incidence.

RECENT FINDINGS

In the SPARCL trial, patients with a recent stroke or transient ischemic attack randomized to atorvastatin 80 mg/day had a significant 16% relative risk reduction of stroke, and a 35% reduction in major coronary events compared with placebo. This was obtained despite 25% of the placebo arm patients receiving a commercially-available statin outside of the trial. Post-hoc analysis used blinded LDL-cholesterol measurements as a marker of adherence to lipid-lowering therapy. Compared with the group with no change or an increase in LDL-cholesterol (the group adherent to placebo or not taking a statin), the group with over 50% reduction in LDL-cholesterol had a significant 31% reduction in stroke. The next step is to define whether achieving LDL-cholesterol below 70 mg/dl is better than a standard dose of statin (LDL around 100-110 mg/dl) in the secondary prevention of stroke.

SUMMARY

Statins are effective in reducing both first-ever and recurrent stroke, and this effect seems driven by the extent of LDL-cholesterol lowering.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Neurology and Stroke Centre, Bichat Hospital, Denis Diderot University and Medical School, Paris, France.

    , ,

    Source

    Current opinion in lipidology 18:6 2007 Dec pg 622-5

    MeSH

    Anticholesteremic Agents
    Humans
    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Ischemic Attack, Transient
    Randomized Controlled Trials as Topic
    Secondary Prevention
    Stroke

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    17993806

    Citation

    Mazighi, Mikael, et al. "Statin Therapy and Stroke Prevention: what Was Known, what Is New and what Is Next?" Current Opinion in Lipidology, vol. 18, no. 6, 2007, pp. 622-5.
    Mazighi M, Lavallée PC, Labreuche J, et al. Statin therapy and stroke prevention: what was known, what is new and what is next? Curr Opin Lipidol. 2007;18(6):622-5.
    Mazighi, M., Lavallée, P. C., Labreuche, J., & Amarenco, P. (2007). Statin therapy and stroke prevention: what was known, what is new and what is next? Current Opinion in Lipidology, 18(6), pp. 622-5.
    Mazighi M, et al. Statin Therapy and Stroke Prevention: what Was Known, what Is New and what Is Next. Curr Opin Lipidol. 2007;18(6):622-5. PubMed PMID: 17993806.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Statin therapy and stroke prevention: what was known, what is new and what is next? AU - Mazighi,Mikael, AU - Lavallée,Philippa C, AU - Labreuche,Julien, AU - Amarenco,Pierre, PY - 2007/11/13/pubmed PY - 2008/1/17/medline PY - 2007/11/13/entrez SP - 622 EP - 5 JF - Current opinion in lipidology JO - Curr. Opin. Lipidol. VL - 18 IS - 6 N2 - PURPOSE OF REVIEW: Randomized trials have shown that statins may reduce the risk of primary stroke. There is no evidence however that statins can reduce recurrent stroke incidence. RECENT FINDINGS: In the SPARCL trial, patients with a recent stroke or transient ischemic attack randomized to atorvastatin 80 mg/day had a significant 16% relative risk reduction of stroke, and a 35% reduction in major coronary events compared with placebo. This was obtained despite 25% of the placebo arm patients receiving a commercially-available statin outside of the trial. Post-hoc analysis used blinded LDL-cholesterol measurements as a marker of adherence to lipid-lowering therapy. Compared with the group with no change or an increase in LDL-cholesterol (the group adherent to placebo or not taking a statin), the group with over 50% reduction in LDL-cholesterol had a significant 31% reduction in stroke. The next step is to define whether achieving LDL-cholesterol below 70 mg/dl is better than a standard dose of statin (LDL around 100-110 mg/dl) in the secondary prevention of stroke. SUMMARY: Statins are effective in reducing both first-ever and recurrent stroke, and this effect seems driven by the extent of LDL-cholesterol lowering. SN - 0957-9672 UR - https://www.unboundmedicine.com/medline/citation/17993806/Statin_therapy_and_stroke_prevention:_what_was_known_what_is_new_and_what_is_next L2 - http://Insights.ovid.com/pubmed?pmid=17993806 DB - PRIME DP - Unbound Medicine ER -