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(Stroke. 2009;40:e622.)
© 2009 American Heart Association, Inc.

Cochrane Corner

Interventions in the Management of Serum Lipids for Preventing Stroke Recurrence

From the Department of Health Sciences (B.N.M.), University of Leicester; and the School of Medicine, Health Policy, and Practice (J.F.P.), University of East Anglia, UK.

Correspondence to Professor John Potter, School of Medicine, Health Policy, and Practice, University of East Anglia, Norfolk NR4 7TJ, UK. E-mail john.potter@uea.ac.uk

Graeme J. Hankey MD, FRCP Section Editor:

Key Words: stroke recurrence • statin • lipids • systematic review

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

	Introduction

 
Studies have shown interventions that reduce total and low-density lipoprotein cholesterol levels also decrease subsequent coronary heart disease (CHD) and stroke events in those with a history of CHD. However, it is uncertain whether pharmacological alteration of lipid levels in those with a history of cerebrovascular disease can prevent recurrence of either stroke or subsequent cardiovascular events.

	Objectives

 
This systematic review investigated the effect of drug therapy to alter serum lipids in preventing subsequent cardiovascular disease and stroke recurrence in patients with a history of stroke or transient ischemia attacks (TIA).

	Search Strategy

 
We searched the Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE. We also contacted pharmaceutical companies known to produce a lipid-lowering agent for information on relevant publications or unpublished work. Randomized trials of participants aged 18 years and over with a history of stroke or TIA were included.

The two review authors independently selected the trials, assessed their quality, and extracted the data. All analyses were carried out using Review Manage 5.0. Differences in outcome between the treatment groups were quantified using the Peto odds ratios (OR), with 95% confidence intervals (CI), from a fixed effects model.

	Main Results

 
Eight trials involving approximately 10 000 participants fit the entry criteria. The active interventions were pravastatin, atorvastatin, or simvastatin in 5 trials, clofibrate in 2, and conjugated estrogen. In those with a previous history of stroke or TIA there was no evidence of a difference overall in stroke recurrence with therapy (OR 0.92, 95% CI 0.81 . . . [Full Text of this Article]