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Statins for the prevention of first or recurrent stroke.
Curr Vasc Pharmacol 2008; 6(2):124-33CV

Abstract

This review considers the evidence showing that statins can prevent first or recurrent stroke or improve its outcome in subjects at moderate or high risk for cardiovascular disease (CVD). Data are reviewed according to trial design (observational or prospective) and baseline CVD risk. Two (ASCOT, CARDS) out of five primary CVD prevention statin trials showed a considerable reduction in stroke rates. In two (MIRACL and PROVE IT) out of five acute coronary syndrome trials, the prevention of first stroke was significant. Most secondary prevention trials (4S, CARE, LIPID, HPS, GREACE and TNT) showed a beneficial effect of statins in stroke prevention. Finally, SPARCL, the only secondary stroke prevention trial in subjects without overt coronary heart disease (CHD), showed a significant reduction in total and ischaemic (fatal and nonfatal) stroke rate, although a small but significant increase in nonfatal haemorrhagic stroke was noted. There was also a significant reduction in CHD-related events. The possible mechanisms responsible for statin-associated stroke prevention are discussed. The evidence suggests the need to consider early and long-term statin treatment (with substantial low-density lipoprotein cholesterol reduction) in all patients at high risk of any type of major vascular event, without discriminating CHD from stroke. Thus, statins may be beneficial to both the heart and the brain.

Authors+Show Affiliations

Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece. athyros@med.auth.grNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

18393914

Citation

Athyros, Vasilios G., et al. "Statins for the Prevention of First or Recurrent Stroke." Current Vascular Pharmacology, vol. 6, no. 2, 2008, pp. 124-33.
Athyros VG, Kakafika AI, Tziomalos K, et al. Statins for the prevention of first or recurrent stroke. Curr Vasc Pharmacol. 2008;6(2):124-33.
Athyros, V. G., Kakafika, A. I., Tziomalos, K., Papageorgiou, A. A., & Karagiannis, A. (2008). Statins for the prevention of first or recurrent stroke. Current Vascular Pharmacology, 6(2), pp. 124-33.
Athyros VG, et al. Statins for the Prevention of First or Recurrent Stroke. Curr Vasc Pharmacol. 2008;6(2):124-33. PubMed PMID: 18393914.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statins for the prevention of first or recurrent stroke. AU - Athyros,Vasilios G, AU - Kakafika,Anna I, AU - Tziomalos,Konstantinos, AU - Papageorgiou,Athanassios A, AU - Karagiannis,Asterios, PY - 2008/4/9/pubmed PY - 2008/7/19/medline PY - 2008/4/9/entrez SP - 124 EP - 33 JF - Current vascular pharmacology JO - Curr Vasc Pharmacol VL - 6 IS - 2 N2 - This review considers the evidence showing that statins can prevent first or recurrent stroke or improve its outcome in subjects at moderate or high risk for cardiovascular disease (CVD). Data are reviewed according to trial design (observational or prospective) and baseline CVD risk. Two (ASCOT, CARDS) out of five primary CVD prevention statin trials showed a considerable reduction in stroke rates. In two (MIRACL and PROVE IT) out of five acute coronary syndrome trials, the prevention of first stroke was significant. Most secondary prevention trials (4S, CARE, LIPID, HPS, GREACE and TNT) showed a beneficial effect of statins in stroke prevention. Finally, SPARCL, the only secondary stroke prevention trial in subjects without overt coronary heart disease (CHD), showed a significant reduction in total and ischaemic (fatal and nonfatal) stroke rate, although a small but significant increase in nonfatal haemorrhagic stroke was noted. There was also a significant reduction in CHD-related events. The possible mechanisms responsible for statin-associated stroke prevention are discussed. The evidence suggests the need to consider early and long-term statin treatment (with substantial low-density lipoprotein cholesterol reduction) in all patients at high risk of any type of major vascular event, without discriminating CHD from stroke. Thus, statins may be beneficial to both the heart and the brain. SN - 1570-1611 UR - https://www.unboundmedicine.com/medline/citation/18393914/Statins_for_the_prevention_of_first_or_recurrent_stroke_ L2 - http://www.eurekaselect.com/82469/article DB - PRIME DP - Unbound Medicine ER -