{"title":"High-dose statins for the prevention of recurrent ischemic stroke: a systematic review and meta-analysis of randomized controlled trials.","authors":"Muhammed Siddique Shahid, Mariam Safwan Bourgleh, Adel Alharfi, Shahad Albariqi, Lamia Albalawi, Rema Alohali, Turki Albaqami, Moaz Safwan Bourgleh","doi":"10.5144/0256-4947.2025.112","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic stroke (IS) is a leading cause of disability and mortality, with fatal outcomes increased with recurrent strokes. This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the safety and efficacy of high-dose statins for secondary IS prevention.</p><p><strong>Methods: </strong>This review was regestered on PROSPERO (registration number: CRD42024574088). Cochrane methodology was followed in this review and comprehensively searched PubMed, Embase, Cochrane Library and clinicaltrial.gov, to include all RCTs conducted from 2004 to 2024, comparing high-dose statins (simvastatin ≥40 mg, atorvastatin ≥40 mg, and rosuvastatin ≥20 mg) with low-dose statins, placebo, or standard care. Outcomes of this review were recurrent IS reduction and adverse events reported in RCTs.</p><p><strong>Results: </strong>Nine RCTs involving 5,503 patients, with male patients ranging from 25.8% to 81.6% were included. Compared to controls, high-dose statins did not significantly reduce risks for secondary IS (OR 0.78, 95% CI [0.61, 1.00], <i>P</i>=.05) and hemorrhagic stroke (OR 0.85, 95% CI [0.56, 1.29], <i>P</i>=.45). Furthermore, no differences were observed in mortality rates and adverse events between groups.</p><p><strong>Conclusion: </strong>Treatment with high dose statins didn't reduce the risk of stroke recurrence or improve mortality, though further research is needed.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 2","pages":"112-128"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Saudi medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5144/0256-4947.2025.112","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/3 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Ischemic stroke (IS) is a leading cause of disability and mortality, with fatal outcomes increased with recurrent strokes. This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the safety and efficacy of high-dose statins for secondary IS prevention.
Methods: This review was regestered on PROSPERO (registration number: CRD42024574088). Cochrane methodology was followed in this review and comprehensively searched PubMed, Embase, Cochrane Library and clinicaltrial.gov, to include all RCTs conducted from 2004 to 2024, comparing high-dose statins (simvastatin ≥40 mg, atorvastatin ≥40 mg, and rosuvastatin ≥20 mg) with low-dose statins, placebo, or standard care. Outcomes of this review were recurrent IS reduction and adverse events reported in RCTs.
Results: Nine RCTs involving 5,503 patients, with male patients ranging from 25.8% to 81.6% were included. Compared to controls, high-dose statins did not significantly reduce risks for secondary IS (OR 0.78, 95% CI [0.61, 1.00], P=.05) and hemorrhagic stroke (OR 0.85, 95% CI [0.56, 1.29], P=.45). Furthermore, no differences were observed in mortality rates and adverse events between groups.
Conclusion: Treatment with high dose statins didn't reduce the risk of stroke recurrence or improve mortality, though further research is needed.
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