Stroke Patients Benefit From Lipitor
Statin Lowered Second Stroke Risk by 16%
WebMD News Archive
Aug. 9, 2006 -- StrokeStroke patients can reduce their risk of having a second stroke by taking high doses of a widely prescribed cholesterol-lowering drug, even if they don't have heart diseaseheart disease, according to a new study.
Researchers say the findings from the five-year, international trial, make it clear that aggressive treatment to lower cholesterol should be considered standard therapy for stroke prevention in people who have already had a stroke.
Patients who took 80 milligrams of the drug Lipitor each day for five years saw a 16% reduction in having another stroke compared with patients who took a placebo. Patients on the cholesterol-lowering drug also experienced a 35% reduction in serious cardiac events.
The study -- called the SPARCL trial -- was funded by Lipitor manufacturer Pfizer, Inc. Pfizer is a WebMD sponsor.
Each year an estimated 15 million people worldwide suffer strokes, and 10 million will either die or remain permanently disabled as a result.
Aggressive cholesterol lowering with statin drugs (such as Lipitor, Zocor, Crestor, or Mevacor) is routinely recommended for patients who have had heart attacks and for those who have a very high risk for heart disease, such as people with diabetesdiabetes.
But it has not been clear if lowering "bad" LDL cholesterolLDL cholesterol is as beneficial for reducing risk in stroke patients without heart disease.
In an effort to answer this question, investigators recruited 4,731 recent stroke and TIA (transient ischemic attack or "ministroke") patients with no history of heart disease. About 60% of participants were men, and the average age was about 63 years old.
The trial included patients treated at sites in Africa, Australia, Europe, the Middle East, and North and South America. All of the patients had experienced either a stroke or TIA within the previous six months. Patients were followed for an average of five years.
Most of the patients were already being treated with aspirin or blood thinners (94%), and roughly two out of three were on blood-pressure-lowering drugs. The included participants had LDL levels from 100 mg/dl to no more than 190 mg/dl. Half the patients in the trial also took 80 milligrams of Lipitor every day and half took a placebo.
After five years of treatment, 265 of the 2,365 patients on Lipitor (11.2%) had had a fatal or nonfatal stroke, compared with 311 of the 2,366 patients (13.1%) who took a placebo.
The overall death rate was similar in the two groups, but significantly fewer patients taking Lipitor had heart attacks.
The study results appear in the Aug. 10 issue of the New England Journal of Medicine.
Benefits vs. Risks
Chicago neurologist K. Michael Welch, MB, ChB, who led the investigation, tells WebMD that the findings argue in favor of adding high-dose Lipitor to the regimen of drugs routinely recommended for strokestroke patients.