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The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study was a large (4731-patient), randomized, controlled, manufacturer-sponsored stroke-prevention trial of atorvastatin in patients with recent stroke or TIA and no known coronary heart disease (N Engl J Med 2006; 355:549). Compared with the placebo group, the atorvastatin group had a significant, 16% lower risk for stroke overall but a significantly higher rate of any hemorrhagic stroke (55 with active treatment vs. 33 with placebo; unadjusted hazard ratio, 1.68) that was attributable entirely to a higher rate of nonfatal hemorrhagic stroke.
The study authors have now performed a post hoc exploratory statistical analysis of the SPARCL data to understand better the…