Reports that statins can help prevent stroke recurrence are already affecting medical practice, he said. "It is almost policy here in the United States to start statin therapy after stroke, even in patients with normal cholesterol levels," Giannopoulos said.
That is true to some extent, added Dr. Gary Abrams, an associate professor of neurology at the University of California, San Francisco.
Statins are "regularly used, certainly, by stroke experts," Abrams said. "It is unclear how well it is permeating the general medical community, but as the evidence unfolds I believe use will be more widespread."
While the Greek study has "a lot of useful information, it has certain weaknesses," Abrams said. "It doesn't really provide information about which statin to use and it doesn't provide information about dosages."
But there's no clear evidence that one statin is better than another, anyway, Abrams said. "My belief is that probably any statin is better than none at all," he said. "In terms of dosage, you have to target that to certain lipid [cholesterol] levels. Which statin? That question is still open."
Abrams agreed that the exact mechanism of action is unclear. "It depends partly on lipid-lowering, partly from reducing inflammation and partly from the direct effect on blood vessels," he theorized.
There's more on stroke treatment at the American Heart Association.
SOURCES: Sotirios Giannopoulos, M.D., assistant professor, neurology, University of Ioannina, Greece; Gary Abrams, M.D., associate professor, neurology
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