Statin Therapy for Secondary Prevention in Ischemic Stroke Patients With Cerebral Microbleeds

Luis Prats-Sanchez1, Pol Camps-Renom1, Philip S Nash1

  • 1From the Department of Neurology (L.P.-S., P.C.-R., A.R.-P., A.M.-D., J.M.-F.), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Stroke Research Centre (P.S.N., D.W., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology; Department of Statistical Science (G.A., J.G.B.), University College London, United Kingdom; Biomedical Research Institute Sant Pau (M.G.-J., Á.L.-G., G.E.D., D.G.-A.), Barcelona, Spain; UCL Stroke Research Centre (H.D.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom; Stroke Research Centre, Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, People's Republic of China; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh, United Kingdom; Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Lysholm Department of Neuroradiology, The National Hospital of Neurology and Neurosurgery, Queen Square London; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; and Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Denmark; A.A. Martinos Center for Biomedial Imaging (H.A.), Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston; Takeda Pharmaceutical Company Limited, Cambridge, MA; Department of Neurology (S.J.), University Hospital Inselspital Bern, University of Bern, Switzerland; Department of Neurology (N.M.B.), Tel-Aviv Sourasky Medical Center; Sackler Faculty of Medicine, Tel-Aviv University, Israel; Department of Neurology (T.G., S.E.); Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Department of Radiology and Nuclear Medicine (D.H.D.-N.), Erasmus MC, Rotterdam, The Netherlands; Department of Cerebrovascular Medicine (M.K., K.T.), National Cerebral and Cardiovascular Centre, Osaka, Japan; Department of Neurology (F.F.), University Hospital of Würzburg, Germany; Stroke and Ageing Research Group (T.G.P.), School of Clinical Sciences at Monash Health; Peninsula Clinical School (V.K.S.), Peninsula Health, Monash University; National Centre for Healthy Ageing, Melbourne, Australia; Department of Neurology (J.H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea; The Neurovascular Research Unit and Health Research Board (P.J.K.), Stroke Clinical Trials Network Ireland, University College Dublin; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Kushiro, Japan; Department of Neurology (J.S., S.K.), Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, The Netherlands; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; Calgary Stroke Program (E.E.S.), Department of Clinical Neurosciences, Radiology and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary; Centre for Clinical Brain Sciences (J.M.W., F.M.C.), Edinburgh Imaging; and UK Dementia Institute at the University of Edinburgh; Centre for Rural Health (S.D.M.), University of Aberdeen, United Kingdom; Department of Neurology (J.-L.M., D.C.), GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266; Univ. Lille (R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Lille, France; Memory Aging and Cognition Centre (C.P.C.), Yong Loo Lin School of Medicine, National University of Singapore,; Department of Brain Sciences (R.V.), Imperial College London, United Kingdom; Department of Neurology, Heidelberg University Hospital, Germany; Department of Neurology (N.K.), National Neuroscience Institute, Singapore; Stroke Research Centre (R.J.S.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology; Comprehensive Stroke Service, University College London Hospitals NHS Trust, United Kingdom; Department of Neurology (F.-E.D.L.), Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Neurology and Stroke Centre (S.T.E.), University Hospital Basel and University of Basel; Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER; University of Basel, Switzerland; Department of Neurology and Stroke Centre (N.P.), University Hospital Basel and University of Basel; Stroke Center Klinik Hirslanden Zürich, Switzerland; Division of Neurology (Y.O.S.), Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong; Department of Neurology and Stroke Centre (A.Z.), University Hospital Basel and University of Basel, Switzerland; Department of Radiology (J.H.), University Medical Center Utrecht; and Department of Clinical Neurophysiology (W.H.M.), Maastricht University Medical Center/Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, The Netherlands.

Neurology
|March 12, 2024
PubMed
Abstract

Related Concept Videos

Lipid-Lowering Drugs: Statins and Miscellaneous Agents01:20

Lipid-Lowering Drugs: Statins and Miscellaneous Agents

Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...