Document Detail


Statins for the prevention of first or recurrent stroke.
MedLine Citation:
PMID:  18393914     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Vasilios G Athyros; Anna I Kakafika; Konstantinos Tziomalos; Athanassios A Papageorgiou; Asterios Karagiannis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current vascular pharmacology     Volume:  6     ISSN:  1570-1611     ISO Abbreviation:  Curr Vasc Pharmacol     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2008-07-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101157208     Medline TA:  Curr Vasc Pharmacol     Country:  United Arab Emirates    
Other Details:
Languages:  eng     Pagination:  124-33     Citation Subset:  IM    
Affiliation:
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece. athyros@med.auth.gr
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / complications,  prevention & control
Cerebrovascular Disorders / complications,  prevention & control
Cholesterol / blood
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Recurrence / prevention & control
Stroke / drug therapy*,  etiology,  prevention & control*
Chemical
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 57-88-5/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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