The impact of statins in stroke risk in patients with a history of cerebrovascular disease had been recently evaluated in the SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol) trial which was published in 2006. A total of 4731 patients with a stroke or TIA within one to six months were included, other inclusion criteria included LDL levels of 2.6 to 4.9 mmol/L, and absence of coronary heart disease. Patients were randomly assigned to atorvastatin 80mg or placebo and were followed up for a median of 4.9 years with a primary end point being the first nonfatal or fatal stroke.
The SPARCL trial has found that statins exert beneficial effects in reducing occurrence of overall stroke. When subtypes of strokes were analysed, statins were associated with a reduction of ischemic stroke but also a significant increase in haemorrhagic stroke risk. Similar results were observed in a subgroup of patients with a history of cerebrovascular disease in the Heart Protection Study in which the use of statins increased the occurrence of haemorrhagic stroke without an effect on overall stroke incidence.
The rest of the RGH E-Bulletin can be read here.
A joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.
Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041.
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