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Predictors of Hemorrhagic Stroke Explored

Risk factors may include atorvastatin treatment, male sex, increased age and hypertension

THURSDAY, Dec. 13 (HealthDay News) -- In patients who have had a recent stroke or transient ischemic attack, treatment with atorvastatin, hemorrhagic stroke as an entry event, male sex, increased age and stage 2 hypertension may be associated with an increased risk of subsequent hemorrhagic stroke, according to study findings published online Dec. 12 in Neurology.

Larry B. Goldstein, M.D., of the Duke University Medical Center in Durham, N.C., and colleagues assessed data from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial and a post-hoc analysis showed 55 patients receiving atorvastatin and 33 patients receiving placebo had subsequent hemorrhagic strokes.

The researchers found that risks for subsequent hemorrhagic stroke after the initial event included atorvastatin treatment (hazard ratio, 1.68), hemorrhagic stroke as the entry event (HR, 5.65), male sex (HR, 1.79), increased age (HR, 1.42 per 10-year increment), and stage 2 hypertension at the most recent study visit (HR, 6.19). However, they found treatment with atorvastatin did not disproportionately affect the risk associated with other factors.

"In making therapeutic decisions, the increase in the risk of hemorrhagic stroke found in SPARCL, if not due to chance, must be balanced against the benefit of treatment with atorvastatin 80 mg per day in reducing the overall risk of stroke, as well as other cardiovascular events found in the study's pre-specified, intention-to-treat analysis," the authors conclude.

Goldstein received honoraria from Pfizer during the course of this study.

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