Original Article HighDose Atorvastatin after Stroke or Transient Ischemic Attack

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Original Article High-Dose Atorvastatin after
Stroke or Transient Ischemic Attack
The Stroke Prevention by Aggressive Reduction in
Cholesterol Levels (SPARCL) Investigators
N Engl J Med Volume 355(6)549-559 August 10, 2006
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Study Overview

• In this five-year placebo-controlled trial
  involving patients who had a recent stroke or
  transient ischemic attack and baseline
  low-density lipoprotein cholesterol levels of 100
  to 190 mg per deciliter (3 to 5 mmol per liter),
  atorvastatin (80 mg daily) resulted in an
  absolute reduction in nonfatal or fatal stroke of
  2.2 percent and of major cardiovascular events of
  3.5 percent

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Screening, Enrollment, and Outcomes
The Stroke Prevention by Aggressive Reduction in
Cholesterol Levels (SPARCL) Investigators. N Engl
J Med 2006355549-559
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Baseline Characteristics of the Patients
The Stroke Prevention by Aggressive Reduction in
Cholesterol Levels (SPARCL) Investigators. N Engl
J Med 2006355549-559
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Estimates of the Hazard Ratio for the Primary and
Secondary Efficacy Outcome Measures
The Stroke Prevention by Aggressive Reduction in
Cholesterol Levels (SPARCL) Investigators. N Engl
J Med 2006355549-559
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Kaplan-Meier Curves for Stroke and TIA
The Stroke Prevention by Aggressive Reduction in
Cholesterol Levels (SPARCL) Investigators. N Engl
J Med 2006355549-559
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Kaplan-Meier Curves for Coronary and
Cardiovascular Events
The Stroke Prevention by Aggressive Reduction in
Cholesterol Levels (SPARCL) Investigators. N Engl
J Med 2006355549-559
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Incidence of Adverse Events and Elevated
Laboratory Values
The Stroke Prevention by Aggressive Reduction in
Cholesterol Levels (SPARCL) Investigators. N Engl
J Med 2006355549-559
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Conclusion

• In patients with recent stroke or TIA and without
  known coronary heart disease, 80 mg of
  atorvastatin per day reduced the overall
  incidence of strokes and of cardiovascular
  events, despite a small increase in the incidence
  of hemorrhagic stroke