Effects of atorvastatin on stroke in patients with unstable angina or non-Q-wave myocardial infarction: a Myocardial
David D Waters1, Gregory G Schwartz, Anders G Olsson
1Division of Cardiology, San Francisco General Hospital, and the University of California, San Francisco School of Medicine, San Francisco, Calif 94110, USA. dwaters@medsfgh.ucsf.edu
Circulation
|September 25, 2002
Summary
Intensive cholesterol lowering with atorvastatin significantly reduced stroke incidence by half in patients with acute coronary syndromes. This treatment did not increase the risk of hemorrhagic stroke over 16 weeks.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- Investigated the impact of intensive cholesterol reduction using atorvastatin.
- Focused on patients with unstable angina or non-Q-wave myocardial infarction.
- Examined stroke as a secondary endpoint in a randomized, placebo-controlled trial.
Purpose of the Study:
- To evaluate the effect of atorvastatin on stroke incidence.
- To assess the safety of intensive cholesterol lowering regarding hemorrhagic stroke.
Main Methods:
- Randomized, placebo-controlled trial over 16 weeks.
- Adjudication of stroke events by a blinded committee.
- Analysis of nonfatal stroke and fatal plus nonfatal stroke occurrences.
Main Results:
- Atorvastatin reduced nonfatal stroke by 60% (RR 0.40, P=0.02).
- Overall stroke rate (fatal and nonfatal) was halved with atorvastatin (RR 0.49, P=0.04).
- No hemorrhagic strokes occurred in the atorvastatin group; all 3 occurred in the placebo group.
Conclusions:
- Intensive cholesterol lowering with atorvastatin significantly reduces stroke risk in acute coronary syndrome patients.
- Atorvastatin did not increase the incidence of hemorrhagic stroke.
- Further trials are recommended to confirm these findings.
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