What Is the Optimal Cholesterol Level After Stroke or TIA?

A randomized trial of two LDL targets suggests that the lower target is better.

Use of statins after ischemic stroke or transient ischemic attack (TIA) has been recommended in guidelines for more than a decade. However, some epidemiologic studies (Stroke 2013; 44:1833) have raised the issue of whether excessive LDL cholesterol lowering increases the risk for brain hemorrhage. The standard treatment of 80 mg atorvastatin comes from a single randomized trial (SPARCL; N Engl J Med 2006; 355:549). Moreover, no randomized trial has compared different LDL targets following stroke.

These investigators enrolled 2860 patients (mean age, 67; 68% male), 86% with a recent ischemic stroke (within 3 months) and 14% with a TIA (within 15 days). Participants were randomized to a lower target of LDL (<70 mg/dL) or a higher target of LDL…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

What Is the Optimal Cholesterol Level After Stroke or TIA?

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Reviewing Author