Cerebrovascular disease and statins
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Author(s)
Beltran Romero, Luis M
Vallejo-Vaz, Antonio J
Muniz Grijalvo, Ovidio
Type
Journal Article
Abstract
Elevated low-density lipoprotein-cholesterol (LDL-C) is a causal factor for the development of atherosclerotic cardiovascular disease (ASCVD); accordingly, LDL-C lowering is associated with a decreased risk of progression of atherosclerotic plaques and development of complications. Currently, statins play a central role in any ASCVD management and prevention strategies, in relation to their lipid-lowering action and potentially to pleiotropic effects. After coronary artery disease, stroke is the most frequent cause of ASCVD mortality and the leading cause of acquired disability, a major public health problem. There is often a tendency to aggregate all types of stroke (atherothrombotic, cardioembolic, and haemorrhagic), which have, however, different causes and pathophysiology, what may lead to bias when interpreting the results of the studies. Survivors of a first atherothrombotic ischemic stroke are at high risk for coronary events, recurrent stroke, and vascular death. Although epidemiological studies show a weak relationship between cholesterol levels and cerebrovascular disease as a whole compared with other ASCVD types, statin intervention studies have demonstrated a decrease in the risk of stroke in patients with atherosclerosis of other territories and a decrease in all cardiovascular events in patients who have had a stroke. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial demonstrated the benefit of high doses of atorvastatin in the secondary prevention of ischemic stroke. In this review, we discuss the evidence, use and recommendations of statins in the primary and secondary prevention of stroke, and their role in other scenarios such as the acute phase of ischemic stroke, cerebral hemorrhage, cardioembolic stroke, small vessel disease, and cognitive impairment.
Date Issued
2021-12-02
Date Acceptance
2021-11-08
Citation
Frontiers in Cardiovascular Medicine, 2021, 8
ISSN
2297-055X
Publisher
Frontiers Media
Journal / Book Title
Frontiers in Cardiovascular Medicine
Volume
8
Copyright Statement
© 2021 Beltrán Romero, Vallejo-Vaz and Muñiz Grijalvo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000730557700001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
atherosclerosis
cerebrovascular disease
LDL-cholesterol
statins
stroke
ACUTE ISCHEMIC-STROKE
WHITE-MATTER HYPERINTENSITIES
RANDOMIZED CONTROLLED-TRIAL
HEALTH-CARE PROFESSIONALS
CORONARY-HEART-DISEASE
INTRACEREBRAL HEMORRHAGE
HYPERTENSIVE PATIENTS
AGGRESSIVE REDUCTION
COGNITIVE FUNCTION
LOWERING TREATMENT
Publication Status
Published
Article Number
ARTN 778740
Date Publish Online
2022-12-02