Cerebrovascular Disease and Statins

Elevated low-density lipoprotein-cholesterol (LDL-C) is a causal factor for the development of atherosclerotic cardiovascular disease (ASCVD); accordingly, LDL-C lowering is associated with a decreased risk of progression of atherosclerotic plaques and development of complications. Currently, statin...

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Autores principales:	Luis M. Beltrán Romero, Antonio J. Vallejo-Vaz, Ovidio Muñiz Grijalvo
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	atherosclerosis cerebrovascular disease LDL-cholesterol statins stroke Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/8a3d8d1292df457a84358aad93f70458
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spelling	oai:doaj.org-article:8a3d8d1292df457a84358aad93f704582021-12-02T08:14:04ZCerebrovascular Disease and Statins2297-055X10.3389/fcvm.2021.778740https://doaj.org/article/8a3d8d1292df457a84358aad93f704582021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.778740/fullhttps://doaj.org/toc/2297-055XElevated low-density lipoprotein-cholesterol (LDL-C) is a causal factor for the development of atherosclerotic cardiovascular disease (ASCVD); accordingly, LDL-C lowering is associated with a decreased risk of progression of atherosclerotic plaques and development of complications. Currently, statins play a central role in any ASCVD management and prevention strategies, in relation to their lipid-lowering action and potentially to pleiotropic effects. After coronary artery disease, stroke is the most frequent cause of ASCVD mortality and the leading cause of acquired disability, a major public health problem. There is often a tendency to aggregate all types of stroke (atherothrombotic, cardioembolic, and haemorrhagic), which have, however, different causes and pathophysiology, what may lead to bias when interpreting the results of the studies. Survivors of a first atherothrombotic ischemic stroke are at high risk for coronary events, recurrent stroke, and vascular death. Although epidemiological studies show a weak relationship between cholesterol levels and cerebrovascular disease as a whole compared with other ASCVD types, statin intervention studies have demonstrated a decrease in the risk of stroke in patients with atherosclerosis of other territories and a decrease in all cardiovascular events in patients who have had a stroke. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial demonstrated the benefit of high doses of atorvastatin in the secondary prevention of ischemic stroke. In this review, we discuss the evidence, use and recommendations of statins in the primary and secondary prevention of stroke, and their role in other scenarios such as the acute phase of ischemic stroke, cerebral hemorrhage, cardioembolic stroke, small vessel disease, and cognitive impairment.Luis M. Beltrán RomeroLuis M. Beltrán RomeroLuis M. Beltrán RomeroAntonio J. Vallejo-VazAntonio J. Vallejo-VazOvidio Muñiz GrijalvoOvidio Muñiz GrijalvoFrontiers Media S.A.articleatherosclerosiscerebrovascular diseaseLDL-cholesterolstatinsstrokeDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atherosclerosis cerebrovascular disease LDL-cholesterol statins stroke Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	atherosclerosis cerebrovascular disease LDL-cholesterol statins stroke Diseases of the circulatory (Cardiovascular) system RC666-701 Luis M. Beltrán Romero Luis M. Beltrán Romero Luis M. Beltrán Romero Antonio J. Vallejo-Vaz Antonio J. Vallejo-Vaz Ovidio Muñiz Grijalvo Ovidio Muñiz Grijalvo Cerebrovascular Disease and Statins
description	Elevated low-density lipoprotein-cholesterol (LDL-C) is a causal factor for the development of atherosclerotic cardiovascular disease (ASCVD); accordingly, LDL-C lowering is associated with a decreased risk of progression of atherosclerotic plaques and development of complications. Currently, statins play a central role in any ASCVD management and prevention strategies, in relation to their lipid-lowering action and potentially to pleiotropic effects. After coronary artery disease, stroke is the most frequent cause of ASCVD mortality and the leading cause of acquired disability, a major public health problem. There is often a tendency to aggregate all types of stroke (atherothrombotic, cardioembolic, and haemorrhagic), which have, however, different causes and pathophysiology, what may lead to bias when interpreting the results of the studies. Survivors of a first atherothrombotic ischemic stroke are at high risk for coronary events, recurrent stroke, and vascular death. Although epidemiological studies show a weak relationship between cholesterol levels and cerebrovascular disease as a whole compared with other ASCVD types, statin intervention studies have demonstrated a decrease in the risk of stroke in patients with atherosclerosis of other territories and a decrease in all cardiovascular events in patients who have had a stroke. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial demonstrated the benefit of high doses of atorvastatin in the secondary prevention of ischemic stroke. In this review, we discuss the evidence, use and recommendations of statins in the primary and secondary prevention of stroke, and their role in other scenarios such as the acute phase of ischemic stroke, cerebral hemorrhage, cardioembolic stroke, small vessel disease, and cognitive impairment.
format	article
author	Luis M. Beltrán Romero Luis M. Beltrán Romero Luis M. Beltrán Romero Antonio J. Vallejo-Vaz Antonio J. Vallejo-Vaz Ovidio Muñiz Grijalvo Ovidio Muñiz Grijalvo
author_facet	Luis M. Beltrán Romero Luis M. Beltrán Romero Luis M. Beltrán Romero Antonio J. Vallejo-Vaz Antonio J. Vallejo-Vaz Ovidio Muñiz Grijalvo Ovidio Muñiz Grijalvo
author_sort	Luis M. Beltrán Romero
title	Cerebrovascular Disease and Statins
title_short	Cerebrovascular Disease and Statins
title_full	Cerebrovascular Disease and Statins
title_fullStr	Cerebrovascular Disease and Statins
title_full_unstemmed	Cerebrovascular Disease and Statins
title_sort	cerebrovascular disease and statins
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/8a3d8d1292df457a84358aad93f70458
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Cerebrovascular Disease and Statins

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