Statins for acute ischemic stroke
Cochrane Reviews,  Clinical Article

Squizzato A et al. – Insufficient data were available from randomized trials to establish if statins are safe and effective in cases of acute ischemic stroke and transient ischemic attack (TIA).

Methods
  • The authors searched the Cochrane Stroke Group's Trials Register (November 2010); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4); MEDLINE (1950 to November 2010); and EMBASE (1980 to November 2010).
  • The authors included all randomized controlled trials (RCTs) comparing statins (any type and dosage) versus placebo or no treatment, administered within two weeks of the onset of acute ischemic stroke or TIA.
  • Two review authors independently selected studies for inclusion and extracted data.
  • The authors assessed methodological quality and, when necessary, contacted study authors for additional data.
  • The authors based quantitative analysis of outcome on the intention–to–treat principle.
  • The primary outcomes were mortality from ischemic stroke and mortality from adverse drug effects, bleedings and infections.
  • The authors estimated the overall treatment effect by the pooled odds ratio (OR) with 95% confidence interval (CI) using a fixed–effect model (Mantel–Haenszel).
  • The authors included eight RCTs involving 625 participants.

Results
  • Only one study was judged as 'low risk' of bias.
  • There were insufficient published data from the eight studies for all planned primary and secondary outcomes.
  • No patients died from ischemic stroke or from adverse drug effects, bleeding or infections among the 444 participants in the six studies where these outcomes were reported.
  • Statin treatment did not reduce all–cause mortality compared with placebo or no treatment (OR 1.51, 95% CI 0.60 to 3.81) in the 431 patients enrolled in seven studies.
  • No cases of rhabdomyolysis (the breakdown of muscle fibres resulting in the release of muscle fibre contents (myoglobin) into the bloodstream) occurred in 274 patients enrolled in three studies.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Internal Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Internal Medicine Articles

1 Effects of tea intake on blood pressure: A meta-analysis of 21 randomized controlled trials JACC - Journal of the American College of Cardiology, October 22, 2014    Clinical Article

2 Sweetened carbonated beverage consumption and cancer risk: Meta-analysis and review European Journal of Cancer Prevention, August 1, 2014    Evidence Based Medicine    Review Article

3 Acupuncture for chronic knee pain: a randomized clinical trial JAMA, October 1, 2014    Evidence Based Medicine    Clinical Article

4 Evaluation and treatment of older patients with hypercholesterolemia: A clinical review JAMA, October 20, 2014    Clinical Article

5 Lower versus higher hemoglobin threshold for transfusion in septic shock New England Journal of Medicine, October 7, 2014    Evidence Based Medicine    Clinical Article

6 Association between circulating 25-hydroxyvitamin D and incident type 2 diabetes: A mendelian randomisation study The Lancet Diabetes & Endocrinology, October 21, 2014    Clinical Article

7 Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review Annals of Internal Medicine, September 29, 2014    Evidence Based Medicine    Review Article    Clinical Article

8 Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial The Lancet, October 16, 2014    Evidence Based Medicine    Clinical Article
Exclusive Author Commentary

9 Total expenditures per patient in hospital-owned and physician-owned physician organizations in California JAMA, October 24, 2014    Evidence Based Medicine    Clinical Article

10 Triglycerides and cardiovascular disease The Lancet, August 19, 2014    Evidence Based Medicine    Clinical Article

11 Nut consumption and the risk of coronary artery disease: A dose–response meta-analysis of 13 prospective studies Thrombosis Research, October 22, 2014    Clinical Article

12 Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak The Lancet, October 23, 2014    Evidence Based Medicine    Clinical Article

13 Association of fat density with subclinical atherosclerosis Full Text Journal of the American Heart Association, September 19, 2014    Free full text

14 A randomized trial of epidural glucocorticoid injections for spinal stenosis New England Journal of Medicine, July 7, 2014    Evidence Based Medicine    Clinical Article

15 Ivabradine in stable coronary artery disease without clinical heart failure New England Journal of Medicine, September 2, 2014    Evidence Based Medicine    Clinical Article

16 Livebirth after uterus transplantation The Lancet, October 9, 2014    Evidence Based Medicine    Clinical Article

17 Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial The Lancet, October 14, 2014    Evidence Based Medicine    Clinical Article

18 Plasma triglycerides predict ten-years all-cause mortality in outpatients with type 2 diabetes mellitus: a longitudinal observational study Full Text Cardiovascular Diabetology, October 17, 2014    Free full text    Clinical Article

19 Readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia among young and middle-aged adults: a retrospective observational cohort study Full Text PLoS Medicine, October 3, 2014    Free full text    Evidence Based Medicine    Clinical Article

20 The influence of whole grain products and red meat on intestinal microbiota composition in normal weight adults: A randomized crossover intervention trial PLOS ONE, October 22, 2014    Clinical Article

Indexed Journals in Internal Medicine: New England Journal of Medicine, The Lancet, Archives of Internal Medicinemore