In multivariate analysis, the SPARCL
investigators found that hemorrhagic stroke risk was increased by an adjusted 68% in patients on atorvastatin, 465% in patients whose prior stroke was hemorrhagic, and 519% in patients with a blood pressure reading of 160-179/100-109 mm Hg at their last clinic visit prior to the hemorrhagic stroke (Neurology.
(5.) Amarenco P, Bogousslavsky I, Callahan A, et al, for the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL
More recent studies focus on the value of intensive statin therapy in high risk patients (TNT, IDEAL) and patients with prior stroke or transient ischemic attack without established CHD (SPARCL
Inme veya GIA oykusu olan hastalarda, atorvastatin 80 mg'in olumcul ve olumcul olmayan inme riskini azaltip azaltmayacagi The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL
) calismasinda test edilmistir (36).
In the SPARCL
trial with 80 mg/d of atorvastatin, subjects were excluded who had pre-existing LDL-C levels higher than 190 mg/dL or less than 100 mg/dL.
The landmark Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL
) trial has recently been published in the New England Journal of Medicine.
Other studies examining aggressive lipid lowering with LIPITOR in more than 40,000 patients include the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial, Stroke Prevention with Aggressive Reduction of Cholesterol Lowering (SPARCL
) trial, and the REVERSAL trial examining atherosclerotic regression with aggressive LDL-C reduction.
Hemorrhagic stroke: In the SPARCL
study (Stroke Prevention by Aggressive Reduction in Cholesterol Levels), 4,731 patients with a recent stroke or transient ischemic attack -67% of which were ischemic strokes, 2% hemorrhagic strokes--were randomized to high-dose atorvastatin or placebo.
Further, the absolute rates of new onset T2DM were 6.40% in the group who took atorvastatin and 6.06% in the placebo group according to the SPARCL
Risk of stroke and cardiovascular events after ischaemic stroke or transient ischaemic attack in patients with type-2 diabetes or metabolic syndrome: secondary analysis of the stroke prevention by aggressive reduction in cholesterol levels (sparcl
(30.) Goldstein LB, Amarenco P, Szarek M, et al; SPARCL
The primary conclusion of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL
) clinical trial was that atorvastatin (Lipitor) reduced stroke risk in general.