European Primary Care Cardiovascular Society

Total vascular events reduced by statin treatment after stroke or TIA

Atorvastatin Reduces First and Subsequent Vascular Events Across Vascular Territories in the SPARCL Trial

Literature - Szarek M, Amarenco P, Callahan A et al. - J Am Coll Cardiol. 2020. doi: 10.1016/j.jacc.2020.03.015

Introduction and methods

Patients with a history of symptomatic ischemic cerebrovascular disease are at continued risk for subsequent events. Studies that focus only on first events do not reflect the total burden of a disease. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial showed that treatment with atorvastatin reduced first occurrence of stroke and first occurrence of a composite outcome of vascular events in patients with recent stroke or transient ischemic attack and no known coronary heart disease, compared to placebo [1]. This post-hoc analysis of the SPARCL trial evaluated the occurrence of total (first and subsequent) vascular events and determined the effect of atorvastatin in reducing these events. In addition, the effect of atorvastatin in reducing events was examined by vascular territory (cerebrovascular, coronary, or peripheral).

The SPARCL trial included patients (≥18 years of age) who had a stroke or transient ischemic attack 1-6 months prior to randomization, LDL-c levels of 100-190 mg/dL (2.6-4.9 mmol/L), and no known coronary heart disease. A total of 4,731 patients were randomized in a 1:1 ratio to receive either atorvastatin (80 mg daily) or matching placebo. The primary analysis of this post-hoc study included first and total vascular events (first and subsequent events). Median follow-up was 4.9 (4.4, 5.5) years.

Main results

Conclusion

This post-hoc analysis of SPARCL trial data showed that treatment with atorvastatin reduced the risk of first and total cerebrovascular, coronary and peripheral vascular events among patients with recent stroke or transient ischemic attack, compared to placebo. Reduction in total events by atorvastatin treatment may be an additional important measure as a reflection of clinical benefit and efficacy and thereby reducing disease burden in these patients.

References

Show references

Find this article online at J Am Coll Cardiol.

Share this page with your colleagues and friends: