STATINSAND STROKE Statins decreases strokesof various etiology by a array of mechanisms, containing modulation ofprecerebral atherothrombosis in the aorta and the carotid artery and thereforeanticipating plaque division and artery-toartery thromboembolism by restrictingcoagulation at its various levels, degenerating tissue factor, innovation ofprothrombin to thrombin activity 4. Vaughan et al. 5have shown in experimental models of ischemic stroke that statin therapy decreasesthe size of brain infarct and ameliorate neurologic after effect by directup-regulation of brain endothelial NO synthase. Additional to that, theanti-inflammatory actions of statins probably contribute to neuroprotection andstroke prevention.
The PravastatinLipids and Atherosclerosis in the Carotids II (PLACII) study also established acognent decline in carotid intimal-medial thickness in pravastatin-treatedpatients. The impact of statin treatment on aortic atherosclerosis has not beenbroadly analysed 5. Decrease in stroke incidence by statins like pravastatin,simvastatin 6 and lovastatin were also accustomed in short-term clinicalstudies 7. In the experimentconducted by The Large Prospective Studies Collaboration Group, there was no correlationbetween cholesterol and stroke. However, they did not categorize betweenischemic and hemorrhagic stroke 8. Cucchiara et al.
8 have shown that theopposing effects of cholesterol on ischemic versus hemorrhagic stroke risk mayconfuse efforts to compare cholesterol levels with stroke except stroke type (i.e. hemorrhagic vs. ischemic) is taken into account. In the Cholesteroland Recurrent Events (CARE) Trial, the pravastatin group had a 31% lowerincidenceof all strokes, even though again the incidence of lethal strokes wasabout the same.
Summarizing, there was no increase in the rate of hemorrhagicstroke 9. On Comparisons ofstatins, Laufs et al. 10 have showed the results that eshtablish thatrosuvastatin is at least as effective as simvastatin and atorvastatin andprovided better protection than lovastatin and mevastatin in the mouse middlecerebral artery (MCA) stroke model.