SPARCL: Sub-analysis in Carotid Stenosis

18 Aug, 10

SPARCL: Sub-analysis in Carotid Stenosis

Introduction

High-dose atorvastatin significantly reduces cerebrovascular and cardiovascular events in carotid stenosis: Analysis of SPARCL trial

Aim

To assess the benefits with high-dose atorvastatin in patients with carotid stenosis

Methods

Analysis of Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Trial

Patients

Transient ischemic attack (TIA) or stroke within last 1-6 months and carotid stenosis (N=1007)

Study Groups

Atorvastatin 80 mg vs. placebo

Mean Duration

4.9 years

Primary Efficacy Outcome

Fatal or nonfatal stroke

Results

High-dose atorvastatin significantly reduced the risk of fatal or nonfatal stroke by 33% vs. placebo (Figure 1)

Figure 1. Incidence of primary end-point in atorvastatin vs. placebo

Risk of TIA or stroke was significantly reduced with atorvastatin by 34% High-dose atorvastatin also significantly reduced the risk of cardiovascular end-points (Table 1)

Table 1. Incidence of cardiovascular end-points

LDL levels were significantly reduced in atorvastatin recipients (70 mg/dl vs. 130 mg/dl in placebo)
Patients attaining LDL <70 mg/dl had less chance of experiencing any of the end-points as compared to those with LDL >100 mg/dl

Safety

There were no significant differences in adverse events in both groups

Conclusion

Intensive lipid lowering with 80 mg atorvastatin significantly reduces the risk of cerebrovascular and cardiovascular events in patients with carotid stenosis.

Stroke published online October 10, 2008