Statintherapy in the primary and the secondary prevention of ischaemic cerebrovascular diseases.
BACKGROUND
Stroke is a major public health problem. It is the third leading cause of death worldwide and results in hospital admissions, morbidity, and long-term disability. Despite the inconsistent or weak association between cholesterol and stroke, statins can reduce the incidence of stroke in high-risk populations and in patients with a stroke or transient ischaemic attack.


METHODS
The aim of our study was to review the efficacy of statin therapy in both primary and secondary stroke prevention. We also reviewed the effectiveness and cost-effectiveness among different statins and we also reviewed the possible effect of treatment added to statin monotherapy.


RESULTS
There is evidence that statin therapy in both primary and secondary prevention significantly reduces subsequent major coronary events but only marginally reduces the risk of stroke recurrence. There is no clear evidence of beneficial effect from statins in those with previous haemorrhagic stroke and it is unclear whether statins should be started immediately post stroke or later. There is a pressing need for direct evidence, from head-to-head trials, to determine whether individual statins provide differing protection from clinically important events in stroke prevention. It is possible that combinations of lipid-lowering agents did not improve clinical outcomes more than high-dose statin monotherapy, although clinical trials are still ongoing.
Feher
Andrea
A
Department of Neurology, University of Pecs, School of Medicine, Pecs, Hungary.
Pusch
Gabriella
G
Koltai
Katalin
K
Tibold
Antal
A
Gasztonyi
Beata
B
Szapary
Laszlo
L
Feher
Gergely
G
D002545:Brain Ischemia / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D002546:Ischemic Attack, Transient / Q000401:mortality / Q000517:prevention & control*; D009017:Morbidity; D012307:Risk Factors; D020521:Stroke / Q000401:mortality / Q000517:prevention & control*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors