There is evidence that statin therapy in patients with a history of ischaemic stroke or TIA significantly reduces subsequent major coronary events but only marginally reduces the risk of stroke recurrence .
There is no clear evidence of beneficial effect from statins in those with previous haemorrhagic stroke and it is unclear whether statins should be started immediately post stroke or later .
BACKGROUND Studies have shown that interventions which reduce total and low-density lipoprotein cholesterol levels also reduce coronary heart disease ( CHD ) and stroke events in those with a history of CHD .
However , it is uncertain whether treatment to alter cholesterol levels can prevent recurrence of either stroke or subsequent cardiovascular events and whether differences in outcomes exist between classes of lipid-lowering therapy .
This is an up date of a Cochrane review first published in 2002 .
OBJECTIVES To investigate the effect of altering serum lipids pharmacologically for preventing subsequent cardiovascular disease and stroke recurrence in patients with a history of stroke .
Serum lipids after stroke
To ascertain the appropriate time for detecting lipid abnormalities for prophylaxis , serial analyses of fasting serum lipoproteins were undertaken prospect ively in men with cerebral infa rct ion or transient ischemic attacks .  Serum total cholesterol ( T CHOL ) and low density lipoprotein cholesterol ( LDL CHOL ) in cerebral infa rct ion patients aged 50 to 69 were lowest on day 7 , intermediate on day 1 , and highest at 3 months , whereas very low density lipoprotein and high density lipoprotein cholesterol ( HDL CHOL ) changed little . The day 1 mean fasting serum HDL CHOL of cerebral infa rct patients was significantly lower in subjects aged 50 to 59 than in those aged 60 to 69 ( 23 ± 3 versus 42 ± 5 mg/dl ) , and there was a corresponding higher ratio of T CHOL : HDL CHOL ( 12.7 ± 4.5 versus 4.7 ± 0.4 , p < 0.01 ) . Mean HDL CHOL levels were low normal to low in patients aged 50 to 69 with transient ischemic attacks . Both serum cholesterol and triglyceride levels are initially decreased in patients aged 50 to 69 with cerebral infa rct ion , whereas only cholesterol is decreased in patients 60 to 69 with transient ischemic attacks . Important lipoprotein abnormalities may be missed in the acute phase
There is evidence that statin therapy in patients with a history of ischaemic stroke or TIA significantly reduces subsequent major coronary events but only marginally reduces the risk of stroke recurrence .
There is no clear evidence of beneficial effect from statins in those with previous haemorrhagic stroke and it is unclear whether statins should be started immediately post stroke or later .
BACKGROUND Studies have shown that interventions which reduce total and low-density lipoprotein cholesterol levels also reduce coronary heart disease ( CHD ) and stroke events in those with a history of CHD .
However , it is uncertain whether treatment to alter cholesterol levels can prevent recurrence of either stroke or subsequent cardiovascular events and whether differences in outcomes exist between classes of lipid-lowering therapy .
This is an up date of a Cochrane review first published in 2002 .
OBJECTIVES To investigate the effect of altering serum lipids pharmacologically for preventing subsequent cardiovascular disease and stroke recurrence in patients with a history of stroke .