Drug insight: translating evidence on statin therapy into clinical benefits

The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial showed that, in patients who had experienced a stroke or transient ischemic attack, treatment with high-dose atorvastatin over a 5-year period significantly reduced the risk of a subsequent stroke. SPARCL also showed that the benefits of an intensive statin regimen in these patients extended beyond reduction of secondary stroke to include significant reductions in future major vascular events. SPARCL has established statin treatment as a key component of a multimodal vascular risk reduction strategy after an ischemic stroke or transient ischemic attack. It is recommended that the vast majority of patients with ischemic cerebrovascular events should be started on statin therapy, preferably before discharge from acute hospitalization for their index event, with the goal of achieving and maintaining consensus guideline cholesterol targets as soon and for as long as possible.