Atorvastatin in stroke: A review of SPARCL and subgroup analysis

Vascular Health and Risk Management

Volumn 6, Issue 1, 2010, Pages 229-236

  Huisa, Branko N ^a   Stemer, Andrew B ^a   Zivin, Justin A ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

Carotid stenosis; Intracranial hemorrhage; Neuroprotection; Outcome; Prevention; Statins; Transient ischemic attack

Indexed keywords

ATORVASTATIN; CHOLESTEROL; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; LOW DENSITY LIPOPROTEIN CHOLESTEROL; PLACEBO;

ADULT; AGED; BRAIN HEMORRHAGE; CAROTID ARTERY OBSTRUCTION; CEREBROVASCULAR ACCIDENT; CHOLESTEROL BLOOD LEVEL; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; DRUG MECHANISM; DRUG MEGADOSE; FEMALE; HUMAN; INCIDENCE; MAJOR CLINICAL STUDY; MALE; MYOPATHY; NEUROPROTECTION; POST HOC ANALYSIS; PRESCRIPTION; RANDOMIZED CONTROLLED TRIAL; REVIEW; RISK REDUCTION; SECONDARY PREVENTION; SIDE EFFECT; TRANSIENT ISCHEMIC ATTACK;

AGE FACTORS; AGED; CAROTID ARTERY DISEASES; CHOLESTEROL, LDL; FEMALE; HEPTANOIC ACIDS; HUMANS; HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS; INTRACRANIAL HEMORRHAGES; ISCHEMIC ATTACK, TRANSIENT; MALE; MIDDLE AGED; PYRROLES; RANDOMIZED CONTROLLED TRIALS AS TOPIC; SEX FACTORS; STROKE; TREATMENT OUTCOME;

EID: 77950838836     PISSN: 11766344     EISSN: 11782048     Source Type: Journal    
DOI: None     Document Type: Review

References (49)

1. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383-1389.
2. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998;339:1349-1357.
3. Plehn JF, Davis BR, Sacks FM, et al. Reduction of stroke incidence after myocardial infarction with pravastatin: the Cholesterol and Recurrent Events (CARE) study. Circulation. 1999;99:216-223.
4. Sever PS, Dahlof B, Poulter NR, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial - Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003;361:1149-1158.
5. Heart Protection Collaborative Study Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomized placebo-controlled trial. Lancet. 2002;360:7-22.
6. Amarenco P, Labreuche J, Lavallée P, Touboul PJ. Statins in stroke prevention and carotid atherosclerosis: systematic review and meta- analysis. Stroke. 2004;35:2902-2909.
7. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549-559.
8. Liao JK. Effects of statins on 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibition beyond low-density lipoprotein cholesterol. Am J Cardiol. 2005;96(Suppl):24F-33F.
9. Zhang L, Zhang ZG, Liu XS, Hozeska-Solgot A, Chopp M. The PI3K/Akt pathway mediates the neuroprotective effect of atorvastatin in extending thrombolytic therapy after embolic stroke in the rat. Arte- rioscler Thromb Vasc Bio. 2007;27:2470-2475.
10. Chen JL, Zhang ZG, Li Y, et al. Statins induce angiogenesis, neurogen- esis, and synaptogenesis after stroke. Ann Neurol. 2003;53:743-751.
11. Kawashima S, Yamashita T, Miwa Y, et al. HMG-CoA reductase inhibitor has protective effects against stroke events in stroke-prone spontaneously hypertensive rats. Stroke. 2003;34:157-163.
12. Lu D, Qu C, Goussev A, et al. Statins increase neurogenesis in the dentate gyrus, reduce delayed neuronal death in the hippocampal CA3 region, and improve spatial learning in rat after traumatic brain injury. J Neurotrauma. 2007;24:1132-1146.
13. Bosel J, Gandor F, Harms C, et al. Neuroprotective effects of atorvastatin against glutamate-induced excitotoxicity in primary cortical neurones. J Neurochem. 2005;92:1386-1398.
14. Laufs U, Gertz K, Huang P, et al. Atorvastatin upregulates type III nitric oxide synthase in thrombocytes, decreases platelet activation, and protects from cerebral ischemia in normocholesterolemic mice. Stroke. 2000;31:2442-2449.
15. Sandercock P, Gubitz G, Foley P, Counsell C. Antiplatelet therapy for acute ischaemic stroke. Cochrane Database Syst Rev. 2003;(2): CD000029.
16. Iso H, Jacobs DRJ, Wentworth D, Neaton JD, Cohen JD. Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the multiple risk factor intervention trial. N Engl J Med. 1989;320:904-910.
17. Yano K, Reed DM, MacLean CJ. Serum cholesterol and hemorrhagic stroke in the Honolulu heart program. Stroke. 1989;20:1460-1465.
18. Ebrahim S, Sung J, Song YM, Ferrer RL, Lawlor DA, Davey Smith G. Serum cholesterol, haemorrhagic stroke, ischaemic stroke, and myo- cardial infarction: Korean national health system prospective cohort study. BMJ. 2006;333:22-28.
19. Leppala JM, Virtamo J, Fogelholm R, Albanes D, Heinonen OP. Different risk factors for different stroke subtypes: association of blood pressure, cholesterol, and antioxidants. Stroke. 1999;30:2535-2540.
20. Goldstein LB, Amarenco P, Szarek M, et al; On behalf of the SPARCL Investigators. Hemorrhagic stroke in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels study. Neurology. 70: 2364-2370.
21. Amarenco P, Goldstein LB, Szarek M, et al; SPARCL Investigators. Effects of intense low-density lipoprotein cholesterol reduction in patients with stroke or transient ischemic attack: The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Trial. Stroke. 2007;38:3198-3204.
22. Amarenco P, Goldstein LB, Callahan A 3rd, et al; SPARCL Investiga- tors Baseline blood pressure, low- and high-density lipoproteins, and triglycerides and the risk of vascular events in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Ath- erosclerosis. 2009;204:515-520.
23. Amarenco P, Goldstein LB, Messig M, et al; SPARCL Investigators. Relative and cumulative effects of lipid and blood pressure control in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels trial. Stroke. 2009;40:2486-2492.
24. Baigent C, Keech A, Kearney PM, et al; Cholesterol Treatment Trial- ists' (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90 056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267-1278.
25. Rothwell PM, Coull AJ, Silver LE, et al. Population-based study of event-rate, incidence, case fatality, and mortality for all acute vascu- lar events in all arterial territories (Oxford Vascular Study). Lancet. 2005;366:1773-1783.
26. Jemal A, Ward E, Hao Y, Thun M. Trends in the leading causes of death in the United States, 1970-2002. JAMA. 2005;294:1255-1259.
27. Sever PA, Dahlof B, Poulter NR, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003;361:1149-1158.
28. Shepherd J, Blauw GJ, Murphy MB, et al. Pravastatin in elderly indi- viduals at risk of vascular disease (PROSPER): a randomized controlled trial. Lancet. 2002;360:1623-1630.
29. Lewis SJ, Moye LA, Sacks FM, et al. Effect of pravastatin on cardiovas- cular events in older patients with myocardial infarction and cholesterol levels in the average range. Ann Intern Med. 1998;129:681-689.
30. Ko DT, Mamdani M, Alter DA. Lipid-lowering therapy with statins in high-risk elderly patients: the treatment-risk paradox. JAMA. 2004;291:1864-1870.
31. Benner JS, Glynn RJ, Mogun H, Neumann PJ, Weinstein MC, Avorn J. Long-term persistence in use of statin therapy in elderly patients. JAMA. 2002;288:455-461.
32. Chaturvedi S, Zivin JA, Breazna A, et al; for the SPARCL investigators. Effect of atorvastatin in elderly patients with a recent stroke or transient ischemic attack. Neurology. 2009;72:688-694.
33. Goldstein LB, Amarenco P, LaMonte M, et al. Relative effects of statin therapy on stroke and cardiovascular events in men and women: Secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Study. Stroke. 2008;39:2444-2448.
34. Amarenco P, Benavente O, Goldstein LB, et al. Results of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial by stroke subtypes. Stroke. 2009;40:1405-1409.
35. Sillesen H, Amarenco P, Hennerici MG, et al; Stroke Prevention by Aggressive Reduction in Cholesterol Levels Investigators. Atorvas- tatin reduces the risk of cardiovascular events in patients with carotid atherosclerosis: a secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Stroke. 2008;39:3297-3302.
36. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid stenosis. JAMA. 1995;273:1421-1428.
37. Halliday A, Mansfield A, Marro J, et al; MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomized controlled trial. Lancet. 2004;363:1491-1502.
38. Goldstein LB, Amarenco P, Zivin J, et al. Statin treatment and stroke outcome in the Stroke Prevention by Aggressive Reduction in Choles- terol Levels (SPARCL) Trial. Stroke. 2009;40:3526-3531.
39. Moonis M, Kane K, Schwiderski U, Sandage BW, Fisher M. HMG-CoA reductase inhibitors improve acute ischemic stroke outcome. Stroke. 2005;36:1298-1300.
40. Elkind MS, Flint AC, Sciacca RR, Sacco RL. Lipid-lowering agent use at ischemic stroke onset is associated with decreased mortality. Neurology. 2005;65:253-258.
41. Aslanyan S, Weir CJ, McInnes GT, Reid JL, Walters MR, Lees KR. Statin administration prior to ischaemic stroke onset and survival: exploratory evidence from matched treatment-control study. Eur J Neurol. 2005;12:493-498.
42. Reeves MJ, Gargano JW, Luo Z, Mullard AJ, Jacobs BS, Majid A. Effect of pretreatment with statins on ischemic stroke outcomes. Stroke. 2008;39:1779-1785.
43. Karki K, Knight RA, Han Y, et al. Simvastatin and atorvastatin improve neurological outcome after experimental intracerebral hemorrhage. Stroke. 2009;40:3384-3389.
44. Lapchak PA, Han MK. The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor simvastatin reduces thrombolytic-induced intracerebral hemorrhage in embolized rabbits. Brain Res. 2009 15;1303:144-150.
45. FitzMaurice E, Wendell L, Snider R, et al. Effect of statins on intracerebral hemorrhage outcome and recurrence. Stroke. 2008;39:2151-2154.
46. Leker RR, Khoury ST, Rafaeli G, Shwartz R, Eichel R, Tanne D; NASIS Investigators. Prior use of statins improves outcome in patients with intracerebral hemorrhage: prospective data from the National Acute Stroke Israeli Surveys (NASIS). Stroke. 2009;40:2581-2584.
47. Amarenco P, Goldstein LB, Sillesen H, et al; Stroke Prevention by Aggressive Reduction in Cholesterol Levels Investigators. Coronary heart disease risk in patients with stroke or transient ischemic attack and no known coronary heart disease: findings from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Stroke. 2010;41:426-430.
48. Fitchett DH, Goodman SG, Langer A. Ischemic stroke: A cardiovascular risk equivalent? Lessons learned from the Stroke Prevention by Aggres- sive Reduction in Cholesterol Levels (SPARCL) trial. Can J Cardiol. 2008;24:705-708.
49. Amarenco P, Steg PG. Stroke is a coronary heart disease risk equivalent: implications for future clinical trials in secondary stroke prevention. Eur Heart J. 2008;29:1605-1607.