Lowering "bad" cholesterol cuts repeat stroke risk

NEW YORK (Reuters Health) - After a stroke or mini-stroke, intensive lowering of "bad" low-density lipoprotein cholesterol with a statin drug significantly reduces the risk of a second stroke, according to new data from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels, or SPARCL, trial.

Previously published data from the trial, which involved more than 4,700 adults, showed that taking 80 milligrams per day of atorvastatin, sold as Lipitor, reduced the risk of stroke and major heart-related events in patients with a history of recent stroke or mini-stroke (also known as transient ischemic attack or TIA).

In taking a second look at the data, Dr. Pierre Amarenco from Bichat University Hospital, Paris, France and the SPARCL team found that patients who achieved a 50 percent or greater reduction in their LDL cholesterol level suffered fewer second stroke events than those who saw no change or an increase in their LDL cholesterol level.

Specifically, compared with no change or an increase in LDL cholesterol, patients achieving a 50 percent or greater reduction in LDL cholesterol had a 31 percent reduction in stroke risk, and a 37 percent reduction in major coronary events.

There was also a trend for a "dose-response" in terms of decreased stroke risk in patients achieving more or less than a 50 decrease in LDL cholesterol. This, the investigators say, favors "the hypothesis that a continuous relationship exists between LDL cholesterol reduction and stroke risk reduction."

SOURCE: Stroke December 2007.