Atorvastatin significantly reduces the risk of a second stroke in patients with no history of heart disease and only mildly elevated cholesterol, according to an article in the August 10 issue of the New England Journal of Medicine. According to data from the National Stroke Association, up to 40 percent of Americans who have had a stroke will experience a second stroke within five years of the first.

The international Stroke Prevention by Aggressive Reduction of Cholesterol Levels (SPARCL) study evaluated 4,731 patients with no history of heart disease who had experienced a stroke or transient ischemic attack within six months of study enrollment. The patients had mildly elevated cholesterol levels and took either 80 mg atorvastatin daily or placebo for an average of five years.

The atorvastatin group had a 16-percent reduction in risk of second stroke compared with the placebo group and a 35-percent reduction in risk of a major coronary event (cardiac death, non-fatal myocardial infarction, or resuscitated cardiac arrest) compared with the placebo group.

“These cardiovascular results are remarkable in a population not known to have had heart disease,” said principal investigator, K. Michael Welch, MD.

He added, “We believe that the findings indicate that Lipitor 80 should become an established part of secondary stroke prevention.”

An analysis of data was conducted after the study ended to explore the types of second stroke that occurred among patients in the study; researchers found that 85 percent of strokes were ischemic. Atorvastatin patients had a 22-percent reduction in risk of ischemic stroke.

Also, the number of patients in the analysis who had a hemorrhagic stroke was very small (atorvastatin 2.3 percent versus placebo 1.4 percent) However, the overall benefit in terms of reducing risk of stroke was still significant despite this increase, and there was no difference in the number of deaths from hemorrhagic stroke between the two groups.

The 16-percent reduction in secondary stroke risk that was achieved through aggressively reducing cholesterol levels of study patients is indeed significant. “These data are important information for physicians because patients who have had a stroke are at much greater risk for suffering another one, yet treatment options to reduce their risk are limited,” commented Welch.