Key result
Statins reduced the relative risk of stroke by 21% and the absolute risk by 0.9% in patients with established or high risk for coronary heart disease.
Why the study?
Do statins reduce stroke incidence in patients with established CHD or at high risk for CHD?
Meta-Analysis (n=70,070)
Do statins reduce stroke incidence in patients with established CHD or at high risk for CHD?
Absolute Risk Reduction: 0.9
Absolute Risk Reduction: 0.9%
Statins significantly reduce the incidence of stroke in patients with established or high risk for coronary heart disease, though their efficacy for primary prevention in the general population or secondary prevention of stroke remains unproven.
Supports statin use for stroke prevention in high-CHD-risk patients; leaves open primary prevention and post-stroke efficacy.
The occurrence of stroke increases with age, particularly affecting the older elderly, a population also at higher risk for coronary heart disease (CHD). Epidemiological and observational studies have not shown a clear association between cholesterol levels and all causes of stroke. Nonetheless, large, long-term statin trials in patients with established CHD or at high risk for CHD have shown that statins decrease stroke incidence in these populations. Combined data from 9 trials including 70,070 patients indicated relative and absolute risk reductions for stroke of 21% and 0.9%, respectively, with statins. The number of strokes prevented per 1000 patients treated for 5 years in patients with CHD is 9 for statins, compared with 17.3 for antiplatelet agents. Statins have not yet been shown to reduce stroke risk in the typical general population without known CHD, nor have they been shown to prevent recurrent stroke in patients with prior stroke. Potential reasons for the effects of statins on stroke and the non-cholesterol-lowering mechanisms that may be involved are discussed. Treatment strategies based on global cardiovascular risk may be most effective. Additional studies in patients representative of the typical stroke population are needed.
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Amarenco et al. (2004) conducted a meta-analysis in Coronary heart disease (CHD) or high risk for CHD (n=70,070). Statins was evaluated on Stroke (Relative risk reduction 21%, absolute risk reduction 0.9%). Statins reduced the relative risk of stroke by 21% and the absolute risk by 0.9% in patients with established or high risk for coronary heart disease.
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