Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Atorvastatin in Stroke

The New England Journal of Medicine has published a study examining the effect of atorvastatin (Lipitor®) on strokes and transient ischaemic attacks (TIAs). The publication of this study has been reported in The Times and the Telegraph newspapers.

The study recruited approximately 4,700 patients who had experienced a stroke between 1 and 6 months prior to randomisation to receive either atorvastatin 80mg or placebo. Follow up was for 5 years and data were collected on fatal and non-fatal stroke, TIAs, cardiovascular events and deaths.

Statistically, there were fewer strokes in the active arm of the study with a reported absolute risk reduction of 2.2%. There was no difference in overall mortality between the groups. There was also an increased risk of haemorrhagic stroke in the active arm.

Journal Watch has appraised the study and noted that the study just achieved statistical significance. Since this is the first study to directly examine the effects of statins on strokes they concluded that it is unclear "whether an 80-mg dose of atorvastatin is necessary to achieve secondary prevention of stroke".

Action: Patients who have already had a stroke should be prescribed a statin as per formulary recommendations to prevent further atherothrombotic events.

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