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(Stroke. 2004;35:2233.)
© 2004 American Heart Association, Inc.

Emerging Therapies

Statin Therapy After Acute Ischemic Stroke in the Heart Protection Study

Is the Role in Recurrent Stroke Prevention Now Defined?

From the Neurology Department, University of Arizona, Tucson, Az.

Correspondence to Dr Bruce M. Coull, Neurology Department, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ 85724-5023. E-mail BCoull@neurology.ahsc.arizona.edu

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

The Heart Protection Study (HPS) recently reported that for individuals at high risk for experiencing vascular occlusive events, simvastatin taken 40 mg/d reduces the relative risk of ischemic stroke by 28% (P<0.001) without consequent increased risk of hemorrhagic stroke.¹ The results of this study are important and should impact practice because HPS is a well-designed, large, prospective, randomized clinical trial with prespecified and adjudicated endpoints. HPS enrolled men and women between the ages of 40 and 80 years with high risk of coronary heart disease, treated hypertension, diabetes mellitus, or occlusive noncoronary artery disease to receive either simvastatin 40 mg per day or placebo. Inclusion criteria required a total cholesterol concentration of at least 135 mg/dL (3.5 mL/L).² Subjects with a history of nondisabling stroke or transient ischemic attack or carotid endarterectomy were also eligible for enrollment. However, excluded were stroke, myocardial infarction, or hospital admission for angina within 6 months of randomization, as well as hepatic disease, severe renal disease, inflammatory muscle diseases, and a variety of other life-threatening conditions or contraindications for the use of statins. The design was a 2x2 factorial using simvastatin 40 mg daily with a matched placebo or antioxidant vitamins with matching placebo capsules. For statin therapy, the study was powered to detect a reduction of 25% in 5-year coronary heart disease mortality, along with a 15% to 20% reduction in all-cause mortality (>90% power, P<0.01). Prespecified secondary analyses included the effects of simvastatin therapy on 10 noncoronary causes . . . [Full Text of this Article]