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Should patients with recent stroke or transient ischemic attack (TIA) receive statins for secondary prevention? In a randomized trial comparing 80 mg/day of atorvastatin with placebo, researchers enrolled 4731 patients (mean age, 63) with stroke or TIA in the previous 1 to 6 months and baseline LDL-cholesterol levels of 100 mg/dL to 190 mg/dL. No subjects had atrial fibrillation, other cardiac sources of embolism, or subarachnoid hemorrhage. Atorvastatin’s manufacturer funded the study.
By 1 month after randomization, the mean LDL level had dropped by 53% with atorvastatin (to 61 mg/dL) but had not changed significantly with placebo. During a median follow-up of 5 years, the incidence of stroke (the primary outcome) was lower with atorvastat…