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AVC : le rôle protecteur des statines réaffirmé
Pierre Amarenco et Julien Labreuche
Juillet 2009

Au terme de leur analyse, les chercheurs de l'Inserm ont montré que, globalement, le recours aux statines a permis de réduire de 18 % le nombre d'attaques, comparé aux groupes contrôles.
Ils montrent que pour toute baisse de 1 mmol de LDL-cholestérol, le risque d'attaque cérébrale diminue de 21 %

Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention
The Lancet Neurology, Volume 8, Issue 5, Pages 453 - 463, May 2009
Pierre Amarenco MD Julien Labreuche BS

Despite the inconsistent or weak association between cholesterol and stroke, lowering of cholesterol concentrations with statins reduces the risk of stroke in high-risk populations and in patients with non-cardioembolic stroke or transient ischaemic attack. Statin therapy is the most important advance in stroke prevention since the introduction of aspirin and antihypertensive treatments.

Meta-analysis of randomised trials of statins in combination with other preventive strategies, including 165 792 individuals, shows that each 1 mmol/L (39 mg/dL) decrease in LDL cholesterol equates to a reduction in relative risk for stroke of 21·1% (95% CI 6·3—33·5, p=0·009). In secondary prevention of non-cardioembolic stroke, intense reduction of LDL cholesterol by statins also significantly reduced the risk of recurrent stroke (relative risk 0·84, 0·71—0·99, p=0·03) and major cardiovascular events (0·80, 0·69—0·92, p=0·002).

Future directions include assessment of a target LDL cholesterol concentration of less than 1·8 mmol/L (70 mg/dL), the effects of triglyceride-lowering therapy alone or in combination with statins, and the effects of treatments to raise HDL cholesterol concentrations.
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