Risk of Second Stroke Is Increased in Patients with Type 2 Diabetes

by Dr Sam Girgis on June 14, 2011

Patients with diabetes and the metabolic syndrome are at increased risk for stroke.  Researchers lead by Dr. Alfred Callahan from Vanderbilt University in Tennessee explored the effects of treatment with atorvastatin (Lipitor) in patients with type 2 diabetes mellitus or metabolic syndrome, and assessed its ability to decrease recurrent stroke risk.  To answer this question, the researchers performed a secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial.  The SPARCL trial was designed to assess the effect of treatment with atorvastatin in reducing stroke in patients with a recent stroke or transient ischemic attack.  In the original study, there were 794 participants identified as having type 2 diabetes, 642 participants identified as having the metabolic syndrome, and 3,295 participants that did not have either.  Dr. Callahan and his team used a secondary statistical analysis of the SPARCL data to determine the effect of treatment with atorvastatin on the risk of stroke, major cardiovascular events, and revascularization procedures in patients with type 2 diabetes and the metabolic syndrome.  The researchers found that in patients with a prior stoke or a transient ischemic attack, diabetes can increase risk for a second stroke, for a major cardiovascular event, and for a revascularization procedure.  The metabolic syndrome increases risk for revascularization procedures, but not for stroke or major cardiovascular events.  In addition, the researchers pointed out that statin treatment was protective for participants, but not beyond the benefit seen for participants without diabetes or metabolic syndrome.  The researchers wrote that “This exploratory analysis found no difference in the effect of statin treatment in reducing these events in subjects with or without type 2 diabetes or [metabolic syndrome]”.  The results of their study were published online today in the Archives of Neurology.  The study was sponsored by Pfizer.  Dr. Callahan received funding support from Pfizer, Bristol Myers Squibb, and Sanofi Aventis.  A second author was employed by and owned stock in Pfizer.


Callahan A, et al. “Risk of stroke and cardiovascular events after ischemic stroke or transient ischemic attack in patients with type 2 diabetes or metabolic syndrome: Secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) TrialArch Neurol 2011; DOI:10.1001/archneurol.2011.146.

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