Statins for stroke prevention : Disappointment and hope
Identifieur interne : 00AA80 ( Main/Exploration ); précédent : 00AA79; suivant : 00AA81Statins for stroke prevention : Disappointment and hope
Auteurs : Pierre Amarenco [France] ; Andrew M. Tonkin [Australie]Source :
- Circulation : (New York, N.Y.) [ 0009-7322 ] ; 2004.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
The occurrence of stroke increases with age, particularly affecting the older elderly, a population also at higher risk for coronary heart disease (CHD). Epidemiological and observational studies have not shown a clear association between cholesterol levels and all causes of stroke. Nonetheless, large, long-term statin trials in patients with established CHD or at high risk for CHD have shown that statins decrease stroke incidence in these populations. Combined data from 9 trials including 70 070 patients indicated relative and absolute risk reductions for stroke of 21% and 0.9%, respectively, with statins. The number of strokes prevented per 1000 patients treated for 5 years in patients with CHD is 9 for statins, compared with 17.3 for antiplatelet agents. Statins have not yet been shown to reduce stroke risk in the typical general population without known CHD, nor have they been shown to prevent recurrent stroke in patients with prior stroke. Potential reasons for the effects of statins on stroke and the non-cholesterol-lowering mechanisms that may be involved are discussed. Treatment strategies based on global cardiovascular risk may be most effective. Additional studies in patients representative of the typical stroke population are needed.
Affiliations:
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Tonkin</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>NHMRC Clinical Research Centre of Excellence in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University</s1><s2>Melbourne, Victoria</s2><s3>AUS</s3><sZ>2 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Melbourne, Victoria</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">05-0179392</idno><date when="2004">2004</date><idno type="stanalyst">PASCAL 05-0179392 INIST</idno><idno type="RBID">Pascal:05-0179392</idno><idno type="wicri:Area/PascalFrancis/Corpus">004A15</idno><idno type="wicri:Area/PascalFrancis/Curation">001688</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">004931</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">004931</idno><idno type="wicri:doubleKey">0009-7322:2004:Amarenco P:statins:for:stroke</idno><idno type="wicri:Area/Main/Merge">00B758</idno><idno type="wicri:Area/Main/Curation">00AA80</idno><idno type="wicri:Area/Main/Exploration">00AA80</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Statins for stroke prevention : Disappointment and hope</title><author><name sortKey="Amarenco, Pierre" sort="Amarenco, Pierre" uniqKey="Amarenco P" first="Pierre" last="Amarenco">Pierre Amarenco</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology and Stroke Center, Bichat-Claude Bernard University Hospital and Medical School, Denis Diderot University-Paris VII</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>'Formation de Recherche en Neurologie Vasculaire (Association Claude Bernard)'</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Tonkin, Andrew M" sort="Tonkin, Andrew M" uniqKey="Tonkin A" first="Andrew M." last="Tonkin">Andrew M. Tonkin</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>NHMRC Clinical Research Centre of Excellence in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University</s1><s2>Melbourne, Victoria</s2><s3>AUS</s3><sZ>2 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Melbourne, Victoria</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Circulation : (New York, N.Y.)</title><title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title><idno type="ISSN">0009-7322</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Circulation : (New York, N.Y.)</title><title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title><idno type="ISSN">0009-7322</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Atherosclerosis</term><term>Cardiovascular disease</term><term>Prevention</term><term>Statin derivative</term><term>Stroke</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Appareil circulatoire pathologie</term><term>Statine dérivé</term><term>Prévention</term><term>Accident cérébrovasculaire</term><term>Athérosclérose</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The occurrence of stroke increases with age, particularly affecting the older elderly, a population also at higher risk for coronary heart disease (CHD). Epidemiological and observational studies have not shown a clear association between cholesterol levels and all causes of stroke. Nonetheless, large, long-term statin trials in patients with established CHD or at high risk for CHD have shown that statins decrease stroke incidence in these populations. Combined data from 9 trials including 70 070 patients indicated relative and absolute risk reductions for stroke of 21% and 0.9%, respectively, with statins. The number of strokes prevented per 1000 patients treated for 5 years in patients with CHD is 9 for statins, compared with 17.3 for antiplatelet agents. Statins have not yet been shown to reduce stroke risk in the typical general population without known CHD, nor have they been shown to prevent recurrent stroke in patients with prior stroke. Potential reasons for the effects of statins on stroke and the non-cholesterol-lowering mechanisms that may be involved are discussed. Treatment strategies based on global cardiovascular risk may be most effective. Additional studies in patients representative of the typical stroke population are needed.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Amarenco, Pierre" sort="Amarenco, Pierre" uniqKey="Amarenco P" first="Pierre" last="Amarenco">Pierre Amarenco</name></region><name sortKey="Amarenco, Pierre" sort="Amarenco, Pierre" uniqKey="Amarenco P" first="Pierre" last="Amarenco">Pierre Amarenco</name></country><country name="Australie"><noRegion><name sortKey="Tonkin, Andrew M" sort="Tonkin, Andrew M" uniqKey="Tonkin A" first="Andrew M." last="Tonkin">Andrew M. Tonkin</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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