Abstract
Use of Statins for Secondary Prevention and Primary Prevention of Ischemic Stroke
Highlights
Hypercholesterolemia was a risk factor for stroke in 1,834 elderly persons [1]
Statins are the only lipid-lowering drugs that have been shown to reduce the incidence of ischemic stroke in patients at risk for ischemic stroke
This review article will discuss the studies demonstrating the efficacy of statins in preventing ischemic stroke and the current guidelines supporting this use of statins
Summary
Hypercholesterolemia was a risk factor for stroke in 1,834 elderly persons [1]. There was a 1.06 times higher probability of developing an Atherothrom Botic Infarction (ABI) for an increment of 10 mg/dl of serum total cholesterol after controlling for other prognostic variables. At 5-year median follow-up of 1,283 patients aged 65 to 74 years at study entry in the Cholesterol and Recurrent Events study involving pravastatin treatment for a period of 5 years in post-myocardial infarction patients and serum total cholesterol levels less than 240 mg/dl and serum Low-Density Lipoprotein (LDL) cholesterol levels of 115 to 174 mg/dl, compared with double-blind placebo, pravastatin 40 mg daily significantly decreased stroke by 40% [Table 1] [5]. The Heart Protection Study randomized 20,536 men and women (5,806 of whom were aged 70 to 80 years) with prior myocardial infarction (8,510 persons), other CHD (4,876 persons), and no CHD (7,150 persons) and a serum total cholesterol level of 135 mg/dl or higher to simvastatin 40 mg daily or to double-blind placebo [6] of the 7,150 persons without CHD, 25% had cerebrovascular disease. At 16-week follow-up, compared with placebo, atorvastatin significantly decreased stroke by 50% [Table 1] [7]
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