Increased Recurrent Stroke Risk in Type 2 Diabetes

No difference in effect of statin treatment in those with, without type 2 diabetes or metabolic syndrome

WEDNESDAY, June 15 (HealthDay News) -- Patients enrolled in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial who have type 2 diabetes may have increased incidence of recurrent stroke and cardiovascular events, but the effect of atorvastatin treatment is independent of whether the patients have type 2 diabetes, or metabolic syndrome (MetS), according to a study published online June 13 in the Archives of Neurology.

Alfred Callahan, M.D., from Vanderbilt University in Nashville, Tenn., and colleagues investigated the efficacy of atorvastatin in reducing the incidence of stroke after recent stroke in the SPARCL trial. Participants included 794 patients with type 2 diabetes mellitus, 642 patients with MetS, and 3,295 reference participants without diabetes or MetS. Primary end points included combined risk of nonfatal and fatal stroke, and secondary end points included major coronary or cardiovascular events, any coronary heart disease event, or revascularization procedure.

The investigators found that patients with type 2 diabetes had a significantly increased risk of stroke (hazard ratio [HR], 1.62), major cardiovascular events (HR, 1.66), and revascularization procedure (HR, 2.39), compared to the reference group. Participants with MetS more frequently underwent revascularization procedures (HR, 1.78). There were no differences in the effect of statin treatment in reducing these events in individuals with or without type 2 diabetes or MetS.

"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," the authors write.

Several of the study authors disclosed financial ties with the pharmaceutical industry, including Pfizer Inc., which sponsored the study.

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