MedWire News: Further results from the SPARCL trial show that stroke patients given atorvastatin have a reduced risk for coronary heart disease (CHD) events, as well as recurrent stroke.

The 4731 patients recruited to the SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) trial were free of known CHD at baseline, so any that manifested during the 4.9-year follow-up represented a first event.

“It is notable that the relative reduction in the risk for major coronary events in SPARCL patients was double that of stroke events,” say Pierre Amarenco (Denis Diderot University, Paris, France) and colleagues.

During follow-up, 5.1% of patients randomly assigned to placebo suffered a major coronary event and 8.6% suffered any CHD event (coronary events plus revascularization, unstable angina, or angina/ischemia requiring hospitalization). In patients taking atorvastatin 80 mg/day, the corresponding rates were 3.4% and 5.2%.

Thus, the risk for major coronary events was reduced by 35% among patients taking atorvastatin and the risk for CHD was reduced by 42%, after accounting for time since entry event, age, and gender.

The risk reductions, while not significant in all subgroups, did not appear to be influenced by whether patients had large-vessel or small-vessel disease.

“Our data, as well as data from long-term observational studies and other clinical trials, show that the risk for myocardial infarction is far from negligible and eventually equals or exceeds the risk for recurrent stroke,” say Amarenco et al in the journal Stroke.

“Long-term studies powered to detect an effect on coronary events should be considered when designing clinical trials in patients with stroke evaluating new treatment strategies.”

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