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Lipitor found to reduce risk of subsequent strokes

Denise Gellene Los Angeles Times

Offering a new way to treat stroke patients, researchers reported Wednesday that high doses of a cholesterol-lowering statin drug could reduce the risk of another attack and stroke-related death.

The statin Lipitor lowered the risk of another stroke by 16 percent and reduced fatal strokes by 40 percent, according to the study published in the New England Journal of Medicine.

While the study looked only at Lipitor, some experts said it was possible that large doses of other statin drugs could have the same effect.

“This is a clear demonstration of the benefits of taking a statin under these circumstances,” said Dr. Steven Nissen of the Cleveland Clinic, a cardiac specialist and statin researcher who was not involved in the study.

In an editorial accompanying the report, Dr. David M. Kent of Tufts-New England Medical Center in Boston said a daily dose of statins will now likely become standard care for certain classes of stroke patients.

“Until today, we didn’t know if there was a reason for a person who had a stroke to be on a statin,” said Dr. Robert Adams, a spokesman for the American Stroke Association.

Adams, a neurologist at the Medical College of Georgia, said the association was likely to review its current treatment guidelines, which list statins as a treatment option, but now stop short of recommending them.

The study, funded by Lipitor maker Pfizer Inc., showed the greatest benefits to patients who suffered strokes caused by clots or blockages that reduce blood flow to the brain, known as ischemic strokes, which account for 88 percent of all strokes.

But patients recovering from a less common form of stroke caused by bleeding in or near the brain, known as hemorrhagic strokes, did worse on Lipitor – a finding some experts said was cause for concern.

Doctors, however, said the problem could be avoided by restricting the use of statins to only ischemic stroke patients.

“The greatest current risk to patients with ischemic stroke vis-a-vis statins remains gross under-treatment,” Kent wrote in his editorial.

The study was the latest to find new uses for cholesterol-lowering drugs. Statins have been shown to reduce the risk of cardiovascular disease and heart attack, and a recent study found the drugs might prevent cataracts. Clinical studies are now under way to see if statins can protect against some cancers.

An estimated 20 million Americans take a statin to prevent excessive cholesterol from forming blockages in their arteries.

For all their benefits, statins are not without risk. The drugs can cause muscle weakness and raise liver enzymes, said Dr. Bruce A. Perler of Johns Hopkins University, who was not involved in the study.

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