"Atorvastatin for Stroke Prevention".The New England Journal of Medicine. 2006. 355(6):549-559. PubMed
Links to original sources: Wiki Journal Post Full Journal Article
Contents 1 Clinical Question 2 Bottom Line 3 Major Points 4 Guidelines 5 Design 6 Population 6.1 Inclusion Criteria 6.2 Exclusion Criteria 6.3 Baseline Characteristics 7 Interventions 8 Outcomes 8.1 Primary Outcome 8.2 Secondary Outcomes 9 Criticisms 10 Funding 11 Further Reading
In patients with recent stroke or TIA and without known coronary heart disease, does atorvastatin reduce the risk of subsequent strokes or cardiovascular events?
In patients with recent stroke or TIA and without known coronary heart disease, daily treatment with 80 mg of atorvastatin reduced the overall incidence of strokes and major cardiovascular events, despite a small increase in the incidence of hemorrhagic stroke.
Although statins are known to reduce the incidence of stroke in patients at increased risk of cardiovascular disease, their efficacy in preventing stroke after a recent stroke or TIA was not well established. SPARCL was therefore designed to investigate whether high-dose atorvastatin therapy could reduce the risk of subsequent stroke in this patient population.
Since the publication of SPARCL, subsequent guidelines have recommended statin therapy for secondary prevention in patients with ischemic stroke or TIA who have evidence of atherosclerosis.
Randomized, double-blind, placebo-controlled trial.
Inclusion Criteria: - Age >18 years - Stroke or TIA within one to six months of study entry - LDL cholesterol levels 100-190 mg/dL - No known coronary heart disease
Exclusion Criteria: - Atrial fibrillation, other cardiac sources of embolism, and subarachnoid hemorrhage
Baseline Characteristics: - Mean age: ~63 years - 60% male - Median LDL cholesterol: ~133 mg/dL - Previous stroke: 66%
- Atorvastatin 80 mg per day versus placebo
Primary Outcome: - First nonfatal or fatal stroke
- Stroke or TIA - Major coronary event - Major cardiovascular event - Acute coronary event - Any coronary event - Revascularization procedure - Any cardiovascular event
- Increased risk of hemorrhagic stroke
Supported by Pfizer.
ClinicalTrials.gov number, NCT00147602