Physicians' Academy for Cardiovascular Education

Prevention of stroke

Slides (presentation) - May 4, 2010

Prevention of stroke
What is the rationale and evidence for lipid intervention

Henrik Sillesen, MD

Rigshospitalet, University of Copenhagen Copenhagen
Denmark
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Prevention of stroke

What is the rationale and evidence for lipid intervention
Henrik Sillesen, MD, Rigshospitalet, University of Copenhagen Copenhagen, Denmark
Rationale for treating lipids in stroke patients!
Does lowering of cholesterol by statins reduce the risk of stroke ?
Primary Prevention ASCOT lla
ASCOT
Primary prevention in Diabetes CARDS Study Design
MEGA trial
JUPITER
JUPITER
Secondary prevention
Heart Protection Study Inclusion criteria
Simvastatin: Major Vascular Event by Prior Disease
HPS: incidence of stroke
HPS: sub-analysis of patients with cerebrovascular disease
Stroke prevention by statins Meta-analysis
Statins and stroke; Other outcomes
Meta- analysis of Cholesterol lowering trials
Statin treatment and stroke prevention
SPARCL: Study Design
Baseline Characteristics
Primary Endpoint: Time to Fatal or Non-Fatal Stroke
Secondary Endpoint: Time to Stroke or TIA
Pre-specified and Post-hoc Analyses
Secondary Endpoint:Time to Major Coronary Event
Selected Secondary Endpoints
Whats new with SPARCL ? Prevention of Stroke + other major vascular events!
Summary: Results of SPARCL
Adherence
LCL-C During Follow-up
SPARCL:On-treatment Analysis
Time-Varying LDL-C and Stroke
Time-Varying LDL-C and Ischemic/Hemorrhagic Stroke
On treatment - prevention of CHD events
Carotid stenosis in SPARCL
Carotid Stenosis
Stroke in Patients With Carotid Stenosis
Any Cardiovascular Event in Patients With Carotid Stenosis
Carotid Endarterectomy in Patients With Carotid Stenosis
Effect of LDL-C in Carotid Stenosis Group
Effect of Atorvastatin on Stroke In SPARCL Patients with Diabetes (n=794)
Effect of Atorvastatin on CV Events In SPARCL Patients with Diabetes
MIRACL: Primary Efficacy Measure: Time to First Event*
Stroke prevention in MIRACL
TNT Stroke 10.000 patients with stable CAD
Deaths Due to Suicide, Cancer, and Hemorrhagic Stroke
Meta-analysis Intensive versus ”conventional” lipid lowering
Summary - stroke prevention

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