From the Guidelines
Atorvastatin should be taken indefinitely after a stroke, unless directed otherwise by a healthcare provider, to reduce the risk of another stroke and improve overall outcomes, as evidenced by the 2021 guideline from the American Heart Association/American Stroke Association 1. The standard dose of atorvastatin for secondary stroke prevention is 80 mg daily, as shown in the SPARCL trial, which found that atorvastatin 80 mg daily reduced stroke recurrence in patients without another indication for statin therapy 1. Key points to consider when taking atorvastatin after a stroke include:
- Taking the medication at the same time each day, usually in the evening
- Attending regular follow-up appointments for blood tests to monitor liver function and lipid levels
- Reporting any side effects, such as muscle pain, digestive issues, or liver enzyme elevations, to a doctor
- Never stopping atorvastatin suddenly without medical guidance, as this could increase the risk of another stroke The TST trial also confirmed that targeting an LDL-C level of <70 mg/dL was superior to a target of 90 to 110 mg/dL for preventing major cardiovascular events, further supporting the use of high-intensity statin therapy, such as atorvastatin 80 mg daily, in patients after ischemic stroke 1.
From the Research
Duration of Atorvastatin Treatment
- The provided studies do not specify the exact duration for which one should take atorvastatin after a stroke 2, 3, 4, 5, 6.
- However, it is recommended that patients should be started on statins after an ischemic stroke, with high doses recommended even if cholesterol concentrations are normal 2.
- The use of statins, such as atorvastatin, is a part of the long-term management of patients with a history of ischemic stroke or transient ischemic attack, suggesting that treatment may be ongoing 3, 5.
- There is no specific information on the duration of atorvastatin treatment, but it is implied that it should be continued as part of secondary stroke prevention, along with other medications such as antiplatelet agents and antihypertensives 2, 3, 5.
Secondary Stroke Prevention
- Secondary stroke prevention includes the use of antiplatelet therapy, statins, and antihypertensives 2.
- The goal of secondary stroke prevention is to reduce the risk of another stroke, and treatment is typically long-term 3, 5.
- The choice of medications and the duration of treatment may vary depending on the individual patient's risk factors and medical history 2, 3, 4, 5, 6.