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 .
Recurrence of bleeding in patients with primary intracerebral hemorrhage.
BACKGROUND AND PURPOSE Rebleeding in patients with primary intracerebral hemorrhage is considered uncommon , but there are no precise data to support this opinion . The purpose of this study was to assess the incidence and predictors of recurrent bleeding in survivors of primary intracerebral hemorrhage . METHODS As part of a prospect i ve study , 112 survivors of a first primary intracerebral hemorrhage were followed up for a mean period of 84.1 months after their discharge . To ascertain risk factors that may influence rebleeding , several demographic , medical history , clinical , and laboratory variables were collected and analyzed . RESULTS Twenty-four percent ( 27/112 ) of survivors experienced one or more rebleeding during the follow-up period , in 8 cases ( 30 % ) in the first year of follow-up ; in the others recurrence occurred later , up to 11.5 years . Rebleeding had a high mortality rate : 70 % of patients died as a consequence of their second or third hemorrhage . Univariate and multivariate analyses showed that lobar location of the first hemorrhage was the only significant predictor of rebleeding . Patients with rebleeding were more frequently older , more often had a history of previous transient ischemic attack or ischemic stroke , and less often had hyperlipidemia than patients without rebleeding , although these correlations did not reach statistical significance . During follow-up , poor control of arterial hypertension was found in 7 % of hypertensive patients without rebleeding and in 47 % of hypertensive patients with rebleeding . CONCLUSIONS Our study showed that rebleeding after a first primary intracerebral hemorrhage is not as uncommon as is usually believed . The risk of rebleeding seems to be particularly high after hemorrhage at the junction of the gray and white matter , a site regarded as typical of hemorrhages due to amyloid angiopathy , and when arterial hypertension is poorly controlled
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 .