Atorvastatine for the prevention of stroke
| Author : Pierre Allain
||Date : 2009-11-10
The same authors published several papers about the benefits of atorvastatin at the dose of 80 mg daily for the prevention of stroke recurrence (study SPARCL, Stroke Prevention by Aggressive Reduction in Cholesterol Levels).
A 2006 paper, published in the NEJM, concludes that atorvastatin reduces the frequency of strokes but without reducing all cause mortality (216 deaths in the atorvastatin group and 211 in the placebo group)
A paper published in Stroke April 2009 concludes that atorvastatin is effective in several types of strokes but overall mortality was not reduced (215 for atorvastatin and 211 for placebo, the authors forgot to indicate in the summary this result concerning mortality).
The third paper published in Stroke September 2009 reports apparently the same data as the previous studies and finds that atorvastatin has beneficial effects compared to the placebo for stroke prevention, although there are little statistically significant differences; otherwise the authors forgot to mention overall mortality in the 2 groups.
A general paper about statins and strokes entitled "Interventions in the management off serum lipids for the prevention off stroke recurrence" published in Stroke (one line September 2009) gives the following conclusions: statins (simvastatine, pravastatin and atorvastatin) do not reduce the frequency of recurrence of strokes (they decrease ischemic forms but increase hemorrhagic forms), nor overall mortality, nor sudden death; nevertheless statin prescription is recommended! The fibrates tested in this study were harmful.
On the whole, there are in publications about statins and strokes some discrepancies between the results of clinical studies which are quite modest and the recommendations to prescribe them.