Statins and stroke: prevention and beyond

Large clinical trials have clearly demonstrated that statins reduce the risk of first and recurrent stroke. This review aims to highlight the current findings and recent developments in this field.

In addition to risk reduction, statins may also improve stroke outcome, even when administered after the event. Due to the multitargeted vasoprotective effects of statins, statins may be beneficial in various conditions and disorders in which acute and chronic endothelial dysfunction play a key role. Vice-versa, abrupt interruption of statin therapy following acute cerebrovascular or cardiovascular events may impede vascular function and increase morbidity and mortality. Furthermore, statins could serve as an adjuvant for enhancing the efficacy of thrombolytic therapy and other promising neuroprotective compounds, as it stabilizes endothelial function and additionally exerts profibrinolytic, immunomodulatory, and antioxidant effects. However, so far, there are only limited clinical data on the effect of statin therapy on stroke outcome.

Statins are emerging as a new and promising avenue for the prevention and potentially treatment of ischemic stroke. New clinical trials are necessary to clarify the impact of acute statin treatment on stroke outcome.