Abstract
To the Editor: The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial enrolled subjects with recent (within 1–6 months) transient ischemic attack or stroke, reporting more frequent brain hemorrhages among those randomly assigned to a statin (hazard ratio=1.66; 95% CI, 1.08–2.55).1 Hackam et al2 write that this finding has “led to some uncertainty regarding the balance of benefits and risks of statins, particularly in patients with a history of cerebrovascular disease.” Notwithstanding their exhaustive meta-analysis, the reason for this concern is not clear. The SPARCL trial, the only randomized trial designed to evaluate a statin in a cerebrovascular population, found a treatment-related reduction in all strokes (hazard ratio=0.84; 95% …
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