Related trials
IMPROVE-IT, 2014 - ezetimibe vs control
AIM-HIGH, 2011 - niacin vs placebo (on top statin)
ACCORD lipid, 2010 - fenofibrate vs placebo (on top simvastatine)
SHARP, 2010 - ezetimibe+simvastatin vs placebo
ARBITER-HALTS 6, 2010 - ezetimibe vs niacin
SEARCH, 2010 - simvastatin high dose vs simvastatin
Oxford Niaspan Study, 2009 - niacin vs placebo (on top statin)
Emmerich, 2009 - etofibrate vs placebo
ARBITER 6-HALTS (niacin vs ezetimibe), 2009 - niacin vs ezetimibe
ARBITER 2, 2009 - niacin vs placebo (on top statin)
GISSI-HF rosuvastatine, 2008 - rosuvastatin vs placebo
JUPITER, 2008 - rosuvastatin vs placebo
SANDS, 2008 - aggressive treatment vs standard teatment
Tuttle, 2008 - low fat diet vs mediterranean-style diet
SAGE, 2007 - atorvastatin high dose vs pravastatin
METEOR, 2007 - rosuvastatin vs placebo
Krum, 2007 - rosuvastatin vs placebo
CORONA, 2007 - rosuvastatin vs placebo
Chello et al., 2006 - preoperative atorvastatin vs placebo
ASPEN, 2006 - atorvastatin vs placebo
SPARCL, 2006 - atorvastatin vs placebo
Patti et al., 2006 - preoperative atorvastatin vs placebo
MEGA, 2006 - pravastatin vs control
FIELD, 2005 - fenofibrate vs placebo
WHI low fat, 2005 - diet vs usual diet
See also:
All cardiovascular prevention clinical trials
All post stroke clinical trials
All clinical trials of cholesterol lowering intervention
All clinical trials of atorvastatin
|
|
Treatments
Studied treatment |
atorvastatin 80mg daily
|
Control treatment |
placebo
|
Patients
Patients |
patients who had had a stroke or TIA within one to
six months before study entry, had low-density lipoprotein (LDL) cholesterol levels
of 2.6 to 4.9 mmol per liter, and had no known coronary
heart disease |
Baseline characteristics |
Age, yr |
62.7 |
male (%) |
59.6 |
stroke as entry event (%) |
69.1 |
TIA as entry event (%) |
30.9 |
Time since entry event, days |
85.7 |
baseline total cholesterol (mg/dL) |
211.9 |
baseline LDL cholesterol (mg/dl) |
133.2 |
baseline HDL cholesterol (mg/dl) |
50 |
baseline triglyceridess (mg/dl) |
143.7 |
|
Method and design
Randomized effectives |
2365 / 2366 (studied vs. control) |
Design |
Parallel groups |
Blinding |
double blind |
Follow-up duration |
4.9y (median) |
Lost to follow-up |
0.53% |
Hypothesis |
Superiority |
Primary endpoint |
nonfatal or fatal stroke |
Results
Endpoint
Studied treat. n/N
Control treat. n/N
Graph
RR [95% CI]
Fatal stroke
24 / 2365
41 / 2366
0,59 [0,36;0,97]
cardiovascular events
334 / 2365
407 / 2366
0,82 [0,72;0,94]
Non fatal stroke
247 / 2365
280 / 2366
0,88 [0,75;1,04]
Coronary event
81 / 2365
120 / 2366
0,68 [0,51;0,89]
Cardiovascular death
78 / 2365
98 / 2366
0,80 [0,59;1,07]
stroke (fatal and non fatal)
265 / 2365
311 / 2366
0,85 [0,73;0,99]
TIA
153 / 2365
208 / 2366
0,74 [0,60;0,90]
All cause death
216 / 2365
211 / 2366
1,02 [0,85;1,23]
stroke or TIA
375 / 2365
476 / 2366
0,79 [0,70;0,89]
0
2
1.0
Relative risks
|
Endpoint |
Events (%) |
Relative Risk |
95% CI |
Endpoint definition in the trial |
Ref |
Studied treat. |
Control treat. |
Fatal stroke
|
24 / 2365 (1,0%) |
41 / 2366 (1,7%) |
0,59 |
[0,36;0,97] |
|
|
cardiovascular events
|
334 / 2365 (14,1%) |
407 / 2366 (17,2%) |
0,82 |
[0,72;0,94] |
|
|
Non fatal stroke
|
247 / 2365 (10,4%) |
280 / 2366 (11,8%) |
0,88 |
[0,75;1,04] |
|
|
Coronary event
|
81 / 2365 (3,4%) |
120 / 2366 (5,1%) |
0,68 |
[0,51;0,89] |
|
|
Cardiovascular death
|
78 / 2365 (3,3%) |
98 / 2366 (4,1%) |
0,80 |
[0,59;1,07] |
|
|
stroke (fatal and non fatal)
|
265 / 2365 (11,2%) |
311 / 2366 (13,1%) |
0,85 |
[0,73;0,99] |
|
|
TIA
|
153 / 2365 (6,5%) |
208 / 2366 (8,8%) |
0,74 |
[0,60;0,90] |
|
|
All cause death
|
216 / 2365 (9,1%) |
211 / 2366 (8,9%) |
1,02 |
[0,85;1,23] |
|
|
stroke or TIA
|
375 / 2365 (15,9%) |
476 / 2366 (20,1%) |
0,79 |
[0,70;0,89] |
|
|
The primary endpoint (if exists) appears in blod characters
|
Reference(s) used for data extraction:
|
Endpoint |
studied treat. |
control treat. |
mean diff |
Absolute risk reduction (for a follow-up of 4.9y (median))
|
Endpoint |
Events rate |
Absolute risk reduction (ARR) |
Studied treat. |
Control treat. |
Fatal stroke |
1,01% |
1,73% |
-0,72%
|
cardiovascular events |
14,12% |
17,20% |
-3,08%
|
Non fatal stroke |
10,44% |
11,83% |
-1,39%
|
Coronary event |
3,42% |
5,07% |
-1,65%
|
Cardiovascular death |
3,30% |
4,14% |
-0,84%
|
stroke (fatal and non fatal) |
11,21% |
13,14% |
-1,94%
|
TIA |
6,47% |
8,79% |
-2,32%
|
All cause death |
9,13% |
8,92% |
0,22%
|
stroke or TIA |
15,86% |
20,12% |
-4,26%
|
Meta-analysis of all similar trials:
cholesterol lowering intervention in cardiovascular prevention for post stroke (or TIA)
cholesterol lowering intervention in cardiovascular prevention for all chronical situations
cholesterol lowering intervention in post stroke for all type of patients
Reference(s)
-
Amarenco P, Bogousslavsky J, Callahan A 3rd, Goldstein LB, Hennerici M, Rudolph AE, Sillesen H, Simunovic L, Szarek M, Welch KM, Zivin JA.
High-dose atorvastatin after stroke or transient ischemic attack..
N Engl J Med 2006 Aug 10;355:549-59
Pubmed
|
Hubmed
| Fulltext
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Amarenco P, Benavente O, Goldstein LB, Callahan A 3rd, Sillesen H, Hennerici MG, Gilbert S, Rudolph AE, Simunovic L, Zivin JA, Welch KM.
Results of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial by stroke subtypes..
Stroke 2009;40:1405-9
Pubmed
|
Hubmed
| Fulltext
|