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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:156.)
© 2003 American Heart Association, Inc.

Editorials

Rapid Effects of Statins

From Prophylaxis to Therapy for Ischemic Stroke

Ulrich Laufs; James K. Liao

From the Vascular Medicine Research Unit (U.L., J.K.L), Cardiovascular Division, Brigham & Women’s Hospital and Harvard Medical School, Boston, Mass; and Medical Clinic III (U.L.), University of Saarland, Homburg, Germany.

Correspondence to James K. Liao, MD, Vascular Medicine Research, 65 Landsdowne St, Room 275, Cambridge, MA 02139. E-mail jliao@rics.bwh.harvard.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Ischemic stroke is a leading cause of death and disability worldwide and is a major contributor to rising healthcare costs. It has been estimated that in the United States, an individual is afflicted with stroke every 53 seconds with fatality occurring about every 2 minutes. Despite recent advances in the treatment of cardiovascular diseases, the therapeutic options for acute ischemic stroke remain limited. For secondary prevention, antiplatelet therapy with aspirin was the only available treatment. However, recent randomized trials with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors or statins have shown remarkable benefits in terms of reducing the incidence of stroke in patients with risks for cardiovascular disease.¹ It is not clear from these studies, however, how much of the benefits were attributed to the reduction of atherosclerotic coronary artery disease because ischemic heart disease is a risk factor for stroke. Nevertheless, several ongoing trials with statins in patients without coronary artery disease should help clarify the extent of stroke protection.

See page 322

Earlier this year, two randomized trials have added important clinical information. The Heart Protection Study (HPS) demonstrated reduction of stroke in a large number of patients irrespective of baseline cholesterol levels and in whom total cholesterol levels were as low as 135 mg/dL.² Furthermore, the analysis of stroke as a predefined secondary endpoint of the Myocardial Ischemia Reduction With Aggressive Cholesterol Lowering (MIRACL) trial showed that early treatment of high-risk patients with acute coronary syndromes halved the incidence of stroke within 4 months.³ These trials demonstrate not . . . [Full Text of this Article]

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