Use of Statins for Preventing Stroke Recurrence: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

GUO Jia ^1,2 , TIAN Jinhui ¹ , YANG Kehu ¹ , REN Yaoyao ¹ , JIANG Lei ¹ ,  SHI Zhenghong ²

1. Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China2. The Second Hospital of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

SHI Zhenghong, Email: guo.xianxian@163.com

Keywords：

Stroke; Recurrence; Statin; Systematic review

DOI：

10.7507/1672-2531.20090103

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess the clinical efficacy of statins for preventing stroke recurrence.
Methods 　We searched The Cochrane Library, PubMed, EMbase, CBM, CSJD, and CJFD for randomized controlled trials on the use of statin drugs to prevent stroke recurrence (up to May 10, 2008), and manually searched key Chinese magazines in the related fields. Two reviewers extracted data independently using a designed extraction form. The quality of included trials was evaluated according to the Cochrane handbook 4.12. RevMan 5.0 software was used for data analysis.
Results 　Six randomized controlled trials involving 9,675 patients were identified. The results of meta-analysis showed that there was no statistical difference in stroke recurrence rate (RR=0.94, 95%CI 0.84 to 1.04, P=0.21) and fatal stroke occurrence (RR=0.77, 95%CI 0.48 to 1.25, P=0.30) between statins and placebo groups, but a significant difference was found between the two groups in transient ischemic attack occurrence (RR=0.80, 95%CI 0.69 to 0.92, P=0.002).
Conclusion 　Current evidence indicates that statin drugs have no superiority to prevent stroke recurrence and fatal stroke occurrence, but can prevent transient ischemic attack.

Citation： GUO Jia,TIAN Jinhui,YANG Kehu,REN Yaoyao,JIANG Lei,SHI Zhenghong. Use of Statins for Preventing Stroke Recurrence: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(5): 565-569. doi: 10.7507/1672-2531.20090103 Copy

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1. 王维治. 主编. 脑血管疾病. 神经病学. 第5版. 北京: 人民卫生出版社, 2004. 126.
2. 苏定冯. 从基础研究看脑卒中防治策略. 中华老年心脑血管病杂志, 2008, 10(2): 86.
3. 陈吉棣. 患过脑血管病是否复发. URL: http://www.xywy.com/jb/neike/sjnk/ncx/20070801/216131.html.
4. 阿托伐他汀钙可降低卒中再发. URL: http://news.pharmnet.com.cn/news/2006/08/18/176079.html.
5. 王文志. 中国脑血管病防治指南节选. 中国慢性病预防与控制, 2006, 14(2): 143.
6. 白毅. 构筑预防卒中复发的防线——专家强调他汀类药物对卒中二级预防的重要作用. 中国医药报, 2007, 102: B6.
7. Winter Y, Wolfram C, Schöffski O. Long-term disease-related costs 4 years after stroke or TIA in Germany. Nervenarzt. 2008. (Online).
8. 赵美英, 刘鸣. 他汀类药物预防脑卒中的高质量临床证据. 中国实用内科杂志, 2007, 27(4): 302-306.
9. 戴京涛. 脑卒中二级预防常识. URL: http://www.ccun.com.cn/jthl/2007/06/14/11047.html.
10. 张茁, 冯立群. 他汀类药物与卒中二级预防. 继续医学教育, 2005, 19(9): 45-47.
11. Collins R, Armitage J, Parish S, et al. Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20536 people with cerebrovascular disease or other high-risk conditions. Lancet, 2004, 363(9411): 757-767.
12. Kennedy J, Hill MD, Ryckborst KJ, et al. Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomized controlled pilot trial. Lancet Neurol, 2007, 6(11): 961-969.
13. Plehn JF, Davis BR, Sacks FM, et al. Reduction of stroke incidence after myocardial infarction with pravastatin: The Cholesterol and Recurrent Events (CARE) Study. Circulation, 1999, (2): 216-223.
14. Shepherd J, Blauw GJ, Murphy MB, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomized controlled trial. Lancet, 2002, 360(9346): 1623-1630.
15. White HD, Simes RJ, Anderson NE, et al. Pravastatin therapy and the risk of stroke. N Engl J Med, 2000, 343(5): 317-326.
16. SPARCL: Stroke Prevention by Aggressive Reduction in Cholesterol Levels.URL: http://www.medscape.com/viewarticle/536377.html.
17. 戢秋明. 脑卒中复发对患者生活质量的影响. 临床心身疾病杂志, 2007, 13(5): 398-399.
18. 不能忽视他汀类药物的副作用 [ E B 7 . s h t m l . O L ] . URL: ht tp: / /www.51dai fu.com/yi shengzhi jia/2006/1124/.
19. DE48722C60D632H4234.

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Use of Statins for Preventing Stroke Recurrence: A Systematic Review

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