Hal J quickly lost all interest in the papal election
when he was hit with a stroke just before Pope Benedict
XVI was chosen. The 69-year-old dairy farmer was following
the election religiously right up until he was rushed
to the hospital. But, as Hal always says, there's no use
crying over spilt milk — nothing can stop the damage
now. Researchers from the University of Massachusetts,
however, bring new hope for stroke victims like Hal. Statins,
which have already been shown to reduce the risk of a
second stroke, may also reduce the damage done by a first
stroke — whether taken before or after the
event.
This is the key finding of research
presented April 12 at the 57th Annual Meeting of the
American Academy of Neurology in Miami Beach. The study
followed 1,618 patients who suffered a first ischemic
stroke. The researchers found that patients who were
given statins after a stroke and those already on these
meds at the time of their stroke were, respectively,
2.6 and 1.6 times more likely to achieve a favourable
outcome than subjects who never received these drugs.
A favourable outcome is defined as survival with discharge
to home, rather than to nursing care.
"These results are very exciting
and suggest that, unless contradicted, all patients
at risk for ischemic stroke or recurrent ischemic stroke
should probably be treated with statins to reduce their
LDL levels to 60-70 mg/dl," says study author Dr Majaz
Moonis, of the University of Massachusetts Medical School
in Amherst.
LIPID
LEVELS NOT A FACTOR?
Dr Moonis notes that the doses required might well be
lower than those used in cholesterol-lowering therapy.
In fact, he doubts that lipid levels have much to do
with the improved stroke recovery seen in his patients.
The study only followed patients for six weeks after
their stroke, too short a period for a significant cholesterol-lowering
effect. However, statins have other properties that
could account for the improvements witnessed in the
study.
"Our research was based on the
data that stroke patients had evidence of inflammation
by elevated C-reactive protein levels. Statins reduce
C-reactive protein, improve the endothelium, and have
an anti-clotting effect," explained Dr Moonis in his
presentation. "Given these properties of statins, it
seemed reasonable to assume that statins would improve
the outcome after stroke." One or more of these properties
is facilitating brain cell repair, he believes.
Also present at the conference
was the vice-chairman of the American Heart Association's
stroke council, Dr Larry Goldstein. A larger trial has
already begun to comprehensively assess the effects
of statins after a stroke, and should report in about
18 months, said Dr Goldstein. For the moment, the Stroke
Council's recommendation that "statin treatment be considered
after a stroke" will stand.
Annual Meeting of the American Academy
of Neurology, presented Apr 12, 2005
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