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Review

HMG CoA reductase inhibitors (statins): use in stroke prevention and outcome after stroke

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Pages 241-247 | Published online: 10 Jan 2014

References

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  • •Discusses in detail the major prospective trials of statins in a meta-analysis framework, with a discussion on lipid-lowering drugs and the differential additive effects of statins.
  • Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. N Engl. Med. 339, 1349–1357 (1998).
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  • ••First study to demonstrate a significantrisk reduction in recurrent ischemic stroke where stroke was a prespecified end point.
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  • •Demonstrates a significant effect of statins in secondary stroke prevention in hypertensive hyperlipidemic patients.
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  • •A negative statin study but demonstrates the same trends as the other positive trials.
  • Schwartz GG, Olsson AG, Ezekowitz MD et al Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA 285, 1711–1718 (2001).
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  • ••Largest and most conclusive study thatdemonstrated a robust effect of simvastatin in secondary stroke prevention. The benefits were equally evident in patients without ischemic heart disease as well as in the older (>75 years) population.
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  • •Demonstrated a trend towards improved outcome after acute ischemic stroke, not observed in any prior study.
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  • ••An important experimental study demonstrating possible mechanisms (enhanced recovery), by which statins may improve after acute ischemic stroke.
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  • •Good paper that discusses the other properties of statins besides their lipid lowering effect, that may be the basis of neuroprotection.
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  • Vaughan CJ, Delanty N, Basson CT Do statins afford neuroprotection in patients with cerebral ischaemia and stroke? CNS DITIF 15, 589–596 (2001).
  • Vaughan CJ, Delanty N, Basson CT Statin therapy and stroke prevention. CUI7: Opin. Calrlial 16, 219–224 (2001).

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