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Statins Seem to Help Stroke Patients

The cholesterol-lowering drugs cut mortality rates, study finds

TUESDAY, April 12, 2005 (HealthDay News) -- Giving cholesterol-lowering drugs called statins to people after they've had a stroke may reduce the brain damage they suffer and decrease their risk of dying.

That finding was presented by researchers Tuesday at the annual meeting of the American Academy of Neurology, in Miami Beach.

The study of more than 1,600 patients found that those given statins after a stroke were 2.6 times more likely to have a favorable outcome, meaning they did not die and were able to go home rather than to a nursing home, said Dr. Majaz Moonis. He is director of the Stroke Prevention Clinic at the University of Massachusetts Memorial Medical Center, in Worcester.

Statins also benefited those who were taking the drugs before they had a stroke, Moonis said. These individuals were 1.6 times more likely to have a favorable outcome than people not taking the medications.

He attributed the benefit not to a reduction in blood cholesterol levels but to the drugs' ability to lower arterial inflammation, as measured by levels of C-reactive protein, a marker of inflammation.

"This is not cholesterol-lowering therapy," Moonis said. "What we are doing is looking at people who are not taking very high doses of a statin."

Previous studies have shown a different beneficial effect of statin treatment -- a lowered risk of a second stroke, Moonis said. The new study looked at the drugs' effect on stroke outcome and found "a significant protective effect, with stroke outcome so much better three months after treatment," he said.

As a result, most stroke patients at Moonis' Massachusetts center are now routinely given statins, Moonis said. The only exceptions are people with unusually low levels of harmful LDL cholesterol, where a further lowering might be harmful, he said. "That is the only case where we draw the line."

Some beneficial effects of statins against stroke have already been acknowledged, said Dr. Larry Goldstein, professor of medicine at Duke University and vice chairman of the American Heart Association's Stroke Council. The council last year recommended using statins to reduce the incidence of recurrent strokes.

But the issue of statin use after a stroke is not yet settled, despite the new report, Goldstein said. Duke researchers will be presenting a report at the same meeting that found no benefit from the drugs after a stroke, based on data from three large Canadian studies, he said.

"But that may have something to do with the way the studies were done," Goldstein said, noting they were not designed to look directly at the effects of statins on stroke risk. "So far, the issue is not clear," he said. "A lot more work needs to be done."

Definitive answers are expected from a large-scale, multi-center study that has already begun, Goldstein said. "Hopefully it will provide clear data to assess the effects of statins given after a stroke." Results are expected in about 18 months, he said.

Meanwhile, the Stroke Council's recommendation that "statin treatment be considered after a stroke" will stand, Goldstein said.

"We're trying to do what we hope will be the right thing," he said.

More information

To learn more about stroke, visit the American Stroke Association, a division of the American Heart Association.

SOURCES: Majaz Monnis, M.D., director, University of Massachusetts Memorial Medical Center Stroke Prevention Clinic, Worcester; Larry Goldstein, professor of medicine, Duke University, Durham, N.C.: April 12, 2005, presentation, American Academy of Neurology's 57th annual meeting, Miami Beach, Fla.
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