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Posted by on Jul 8, 2014 in Stroke | 0 comments

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In a nutshell

This study examined the effect of statins on mortality (death) and stroke recurrence in patients with cardioembolic stroke.

Some background

Cholesterol is known to play a major role in the development of cardiovascular disease, including strokes. Cholesterol reducing drugs such as statins, which inhibit the synthesis of cholesterol in the liver, have been shown to reduce the incidence of heart attacks and general cardiovascular mortality among high risk patients. 

Cardioembolic stroke is a stroke caused by a thrombus (a blood clot) formed in the heart. This thrombus may reach blood vessels in the brain, obstruct them, consequently depriving parts of the brain from blood leading to a stroke. The beneficial effects of statins in patients with noncardioembolic stroke have been well documented. However, statin therapy in patients with cardioembolic stroke has not been supported by clinical evidence.

Methods & findings

This study was analyzed retrospectively (analysis of events that have already taken place). A total of 535 patients diagnosed with first-time cardioembolic stroke were analyzed. These patients were classified into 2 groups. Patients in the first group (240 patients) were treated with statins after stroke occurrence. Statins used included atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastastin (Zocor). Patients in the second group (295 patients) did not receive statin treatment after their stroke occurred. Patients in first group were further divided into high-potency and low-potency statin groups. The high-potency statin group was defined by patients who were prescribed a dose and type of statin that was expected to reduce their initial cholesterol level by more than 50%.

The average follow-up duration for all patients was 22.2 months after which results were analyzed. The mortality rate was 7% at the end of the first year and 10% at the end of the third year. The rate of recurrent stroke was 5% at the end of the first year and 13% at the end of the third year.

 Researchers concluded that in patients with cardioembolic stroke, statin use was independently associated with reduced mortality. Those who were treated with low-potency statins had a 76.3% reduced mortality risk compared to those who were not taking statins. Those who were treated with high-potency statins had an 84.2% reduced mortality risk compared to those who were not taking statins. The difference between the high-potency and low-potency statin groups was not deemed to be statistically significant.  

However, statin treatment did not affect the incidence of recurrent stroke in patients with cardioembolic stroke.

The bottom line

This study concluded that statin therapy could be associated with reduced mortality in patients with cardioembolic stroke. 

The fine print

Large, randomized, controlled studies should be performed to confirm the effect of statins on cardioembolic stroke

Published By :

Stroke

Date :

May 06, 2014

Original Title :

Statins Improve Survival in Patients With Cardioembolic Stroke.

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