Abstract
Background: Over the last decades, the reduction of the mortality and morbidity of stroke has been a high- priority objective worldwide. Statins, or 3-hydroxy-3- methylglutaryl coenzyme A (HMG- CoA) reductase inhibitors, have emerged as the predominant preventive strat egy to tackle the worldwide stroke burden. Currently, statins are considered the most important advance in stroke prevention since the introduction of aspirin and antihypertensive treatments. Methods: In this paper we review the current evidence regarding the role of statins in the stroke prevention and future directions in this field. Results: A meta-analysis of random ised trials of statins has shown that each 1 mmol/L (39 mg/dL) decrease in low-density lipoprotein cholesterol, equates to a reduction in relative risk for stroke of 21.1%. Statins are now recommended for the primary prevention of ischemic stroke in patients estimated to have a high 10-year risk for cardiovascular events. Nevertheless, until recently there was little evidence that statin therapy reduced the risk of stroke recurrence. The SPARCL, published in 2006, was the first trial to show the benefits of statin therapy in preventing recurrent stroke. Now we know that statins reduce the risk of stroke recurrence by 12-16% and statins are recommended among patients with ischemic stroke or TIA presumed to be of atherosclerotic origin or with other comorbid atherosclerotic cardiovascular disease. Conclusion: Traditionally, there has been no clear data demonstrating that adding other lipid-modifying drugs to statins results in a further decrease in stroke or other cardiovascular event, but now things have changed and future directions include combinations with ezetimibe and new treatments such as PCSK9 inhibitors. Only time will tell the real roll of these new promising non-statin lipidmodifying therapies on stroke prevention.
Keywords: Statins, stroke prevention, primary prevention, secondary prevention, ezetimibe, PCSK9 inhibitors.
Current Pharmaceutical Design
Title:Statins in Stroke Prevention: Present and Future
Volume: 22 Issue: 30
Author(s): Luis Castilla-Guerra, María del Carmen Fernandez-Moreno and Miguel Angel Colmenero-Camacho
Affiliation:
Keywords: Statins, stroke prevention, primary prevention, secondary prevention, ezetimibe, PCSK9 inhibitors.
Abstract: Background: Over the last decades, the reduction of the mortality and morbidity of stroke has been a high- priority objective worldwide. Statins, or 3-hydroxy-3- methylglutaryl coenzyme A (HMG- CoA) reductase inhibitors, have emerged as the predominant preventive strat egy to tackle the worldwide stroke burden. Currently, statins are considered the most important advance in stroke prevention since the introduction of aspirin and antihypertensive treatments. Methods: In this paper we review the current evidence regarding the role of statins in the stroke prevention and future directions in this field. Results: A meta-analysis of random ised trials of statins has shown that each 1 mmol/L (39 mg/dL) decrease in low-density lipoprotein cholesterol, equates to a reduction in relative risk for stroke of 21.1%. Statins are now recommended for the primary prevention of ischemic stroke in patients estimated to have a high 10-year risk for cardiovascular events. Nevertheless, until recently there was little evidence that statin therapy reduced the risk of stroke recurrence. The SPARCL, published in 2006, was the first trial to show the benefits of statin therapy in preventing recurrent stroke. Now we know that statins reduce the risk of stroke recurrence by 12-16% and statins are recommended among patients with ischemic stroke or TIA presumed to be of atherosclerotic origin or with other comorbid atherosclerotic cardiovascular disease. Conclusion: Traditionally, there has been no clear data demonstrating that adding other lipid-modifying drugs to statins results in a further decrease in stroke or other cardiovascular event, but now things have changed and future directions include combinations with ezetimibe and new treatments such as PCSK9 inhibitors. Only time will tell the real roll of these new promising non-statin lipidmodifying therapies on stroke prevention.
Export Options
About this article
Cite this article as:
Castilla-Guerra Luis, del Carmen Fernandez-Moreno María and Colmenero-Camacho Angel Miguel, Statins in Stroke Prevention: Present and Future, Current Pharmaceutical Design 2016; 22 (30) . https://dx.doi.org/10.2174/1381612822666160510125229
DOI https://dx.doi.org/10.2174/1381612822666160510125229 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Gender Disparity in Lipid Target Achievements in High and Very High Atherosclerotic Cardiovascular Disease Risk Patients in the Arabian Gulf
Current Vascular Pharmacology Plant Sterols and Stanols in the Treatment of Dyslipidemia: New Insights into Targets and Mechanisms Related to Cardiovascular Risk
Current Pharmaceutical Design Microbial Biotransformation: Recent Developments on Steroid Drugs
Recent Patents on Biotechnology Non-invasive Atherosclerosis Imaging: Use to Assess Response to Novel or Combination Lipid Therapies
Current Drug Targets - Cardiovascular & Hematological Disorders Cellular Localisation of Chromogranins and Processed Products in the Diffuse Neuroendocrine System and Related Tumours
Current Medicinal Chemistry - Immunology, Endocrine & Metabolic Agents Statin Intolerance: Why and What to do – With a Focus on Diabetic People
Current Medicinal Chemistry Surgical Ventricular Restoration: An Operation to Reverse Remodeling - Clinical Application (Part II) (Supplementry Table)
Current Cardiology Reviews Leptin-Induced Endothelial Dysfunction: A Target for Therapeutic Interventions
Current Pharmaceutical Design Use of Non-Selective Non-Steroidal Anti-Inflammatory Drugs in Relation to Cardiovascular Events. A Systematic Pharmacoepidemiological Review
Current Vascular Pharmacology Chips for Brains
Current Genomics Mitochondrial Aldehyde Dehydrogenase, A Potential Drug Target for Protection of Heart and Brain from Ischemia/Reperfusion Injury
Current Drug Targets Magnesium as a Neuroprotective Agent in Cerebral Ischemia
Current Medicinal Chemistry - Central Nervous System Agents Voltage-Gated Sodium Channels: Mutations, Channelopathies and Targets
Current Medicinal Chemistry Cardiac Complications Attributed to Hydroxychloroquine: A Systematic Review of the Literature Pre-COVID-19
Current Cardiology Reviews Preface [Hot Topic: Heparin and Heparinoids: Correlation between Structure and antithrombotic activity. Clinical Applications and Future Perspectives (Executive Editor: Carl P. Dietrich)]
Current Pharmaceutical Design Injecting Illicit Substances Epidemic and Infective Endocarditis
Infectious Disorders - Drug Targets Hemodynamic Monitoring in the Acute Management of Pediatric Heart Failure
Current Cardiology Reviews Disruption of Circadian Rhythms in Critical Illness - A Role of Hyperoxia-Induced Lung Injury
Current Pharmaceutical Design Effect of Doxycycline on Atherosclerosis: From Bench to Bedside
Recent Patents on Cardiovascular Drug Discovery Adiponectin - A Novel Anti-Atherogenic Factor in the Metabolic Syndrome: Mechanisms of Action and Therapeutic Potential
Vascular Disease Prevention (Discontinued)