Statins Prevent Stroke Recurrences… But Can They Improve Stroke Outcome?

First, multiple studies firmly established the value of statins in reducing the risk of ischemic stroke among patients with cardiovascular disease. Then the truly seminal Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial showed that high-dose atorvastatin reduced the risk of subsequent stroke in patients without known coronary artery disease who had a recent stroke or transient ischemic attack before enrollment. Now, in this issue of Stroke, the SPARCL investigators present data suggesting that high-dose statin might also reduce the severity of recurrent strokes. Can it be true that statins may not only prevent progression of vascular disease, but also be neuroprotectants or enhance recovery from neurological injury?

There is convincing experimental evidence indicating that statins have various potentially neuroprotective properties, including amelioration of glutamate-mediated excitotoxicity, attenuated production of reactive oxygen species, upregulation of endothelial nitric oxide synthase with favorable effects on the microcirculation, diminished inflammatory reaction by modulation of the cytokine response, and promotion of angiogenesis, which could improve the availability of collateral vessels. Flow in the microcirculation could also be enhanced by statins due to antiplatelet and profibrinolytic effects. Furthermore, statins could positively impact brain regeneration by stimulating neurogenesis and angiogenesis. Go to Source

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