Atorvastatin not benficial for secondary prevention of stroke in diabetics

January 01, 0001

Atorvastatin not benficial for secondary prevention of stroke in diabetics

This report is a secondary analysis by authors from multiple countries of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial, which tested the effect of treatment with atorvastatin in reducing stroke in subjects with a recent stroke or transient ischemic attack. Their purpose was to explore the effects of treatment in subjects with type 2 diabetes mellitus or metabolic syndrome (MetS). The 4731 subjects enrolled in the SPARCL trial were classified as having type 2 diabetes mellitus at enrollment (n = 794), MetS retrospectively (n = 642), or neither diabetes nor MetS (n = 3295, the reference group) based on data collected at baseline.

They found: "Subjects with type 2 diabetes mellitus had increased risks of stroke (HR = 1.62), major cardiovascular events (HR = 1.66), and revascularization procedures (HR = 2.39) compared with the reference group. Subjects with MetS were not at increased risk for stroke or major cardiovascular events but more frequently had revascularization procedures (HR = 1.78). There were no treatment x subgroup interactions for the SPARCL primary end point."

The authors concluded: "The SPARCL subjects with type 2 diabetes were at higher risk for recurrent stroke and cardiovascular events. This exploratory analysis found no difference in the effect of statin treatment in reducing these events in subjects with or without type 2 diabetes or MetS."

It is good to know what doesn’t work as well as what does.

For the full abstract, click here.

Arch Neurol 68(10):1245-1251, October 2011 © 2011 to the American Medical Association
Risk of Stroke and Cardiovascular Events After Ischemic Stroke or Transient Ischemic Attack in Patients With Type 2 Diabetes or Metabolic Syndrome-Secondary Analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Trial. Alfred Callahan, Pierre Amarenco, Larry B. Goldstein, et al. Correspondence to Dr. Callahan: stealthasc@earthlink.net

Category: N. Neurological, K. Circulatory, T. Endocrine/Metabolic/Nutritional. Keywords: stroke, transient ischemic attack, TIA, secondary prevention, atorvastatin, diabetes mellitus type 2, metabolic syndrome, secondary analysis of randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 21 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.