Literature Review of Statins and Ischemic Stroke: Are They Effective at Reducing the Risk?

Conley, Joyce PhD, RN, Shawn Coleman, and Sally Khemmoro

Background:

Stroke continues to be a significant problem in the United States, with approximately 85% of strokes being ischemic in nature.  Of ischemic strokes, 25 to 29% of those are recurrent strokes, striking the same individual repeatedly.  Statin medications (HMG-CoA reductase inhibitors) are medications that have proven successful in reducing cardiovascular ischemic events, and are being studied as a method of preventing ischemic cerebrovascular events, though no definitive guideline has been developed concerning this application.

Methods:

A search of databases including Science Direct and PubMed resulted in 6 articles, which were reviewed for relevant study results.

Results:

Variable levels of support for the use of statins in the setting of ischemic stroke prevention were found among the studies reviewed, but all studies showed some level of risk reduction, ranging from 3.5% to 32%.  The reduction in ischemic events was accompanied by slight increases in the number of hemorrhagic events in all studies reviewed, though the reduction in risk of ischemic events outweighed the increased risk of hemorrhagic events in all cases, and by a large margin in several of the studies. 

Conclusions:

While there is evidence that the use of statins can have a positive effect on reducing the occurrence and recurrence of ischemic strokes, the wide range of results suggests that there may be other factors that can influence the efficacy of this treatment.  Further research needs to be done to identify these variables, and to further clarify the role of statins in the increased incidence of hemorrhagic events.  Overall, it does appear that the use of statins has promise in reducing ischemic cerebrovascular events.