Trial reportStroke2009
Results of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial by stroke subtypes.
Trial report in Stroke, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06649240 (Optimal Target Low-density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke), which is not on this map. Cited by 89 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Optimal Target Low-density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke (SVO70)
Who cites it
89 citing papers in PubMed, 2 syntheses or guidelines pooled it, 265 citations in OpenAlex.
- European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke.European stroke journal · 2024Guideline
- Effect of atorvastatin on testosterone levels.The Cochrane database of systematic reviews · 2021Pooled it
- Statin initiation and early stroke recurrence in the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial (POINT) trial population.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025Trial
- Different Influences of Statin Treatment in Preventing At-Risk Stroke Subtypes: A Post Hoc Analysis of J-STARS.Journal of atherosclerosis and thrombosis · 2020Trial
- Pre-operative Carotid Plaque Echolucency Assessment has no Predictive Value for Long-Term Risk of Stroke or Cardiovascular Death in Patients Undergoing Carotid Endarterectomy.European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2017Trial
- The Japan Statin Treatment Against Recurrent Stroke (J-STARS): A Multicenter, Randomized, Open-label, Parallel-group Study.EBioMedicine · 2015 · on this mapTrial
- Rationale, design, and baseline features of a randomized controlled trial to assess the effects of statin for the secondary prevention of stroke: the Japan Statin Treatment Against Recurrent Stroke (J-STARS).International journal of stroke : official journal of the International Stroke Society · 2014Trial
- Reduction in early stroke risk in carotid stenosis with transient ischemic attack associated with statin treatment.Stroke · 2013Trial
- Trial
- Optimal LDL-C Levels for Ischemic Stroke Prevention: A Neurologist's Perspective.Journal of lipid and atherosclerosis · 2026Review
- SVO70 (Optimal Target Low-Density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke): Rationale and Study Design.Journal of the American Heart Association · 2026Article
- CerebrAlcare Pills on CereBral Small VesseL DiseasE (CABLE) trial: rationale and design.Stroke and vascular neurology · 2026Article
- Cryptogenic stroke: definitions and management.Hematology. American Society of Hematology. Education Program · 2025Review
- Statin therapy reduces vertebral artery atherosclerotic plaques: a case report with insight from vessel wall magnetic resonance imaging.Quantitative imaging in medicine and surgery · 2025Article
- ETRAISI registry report: clinical characteristics and related factors of outcome in reperfusion-eligible AIS patients.BMC neurology · 2025Article
- Acute Ischemic Stroke in the Setting of Neurosarcoidosis.Clinical case reports · 2025Article
- Patterns and predictors of statin therapy after ischemic stroke and TIA: insights from the LIPYDS multicenter study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Observational
- Intensity of statin therapy after ischaemic stroke and long-term outcomes: a nationwide cohort study.Stroke and vascular neurology · 2025Article
- Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment.Journal of the American Heart Association · 2025Article
- Early statin use might reduce the hemorrhagic transformation among acute ischemic stroke patients with recanalization therapy: a retrospective cohort study.Frontiers in pharmacology · 2025Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe SPARCL trial showed that atorvastatin 80 mg/d reduces the risk of stroke and other cardiovascular events in patients with recent stroke or transient ischemic attack (TIA). We tested the hypothesis that the benefit of treatment varies according to index event stroke subtype.
methodsSubjects with stroke or TIA without known coronary heart disease were randomized to atorvastatin 80 mg/d or placebo. The SPARCL primary end point was fatal or nonfatal stroke. Secondary end points included major cardiovascular events (MCVE; stroke plus major coronary events). Cox regression models testing for an interaction with treatment assignment were used to explore potential differences in efficacy based on stroke subtype.
resultsFor subjects randomized to atorvastatin versus placebo, a primary end point occurred in 13.1% versus 18.6% of those classified as having large vessel disease (LVD, 15.8% of 4,731 participants), in 13.1% versus 15.5% of those with small vessel disease (SVD, 29.8%), in 11.2% versus 12.7% of those with ischemic stroke of unknown cause (21.5%), in 7.6% versus 8.8% of those with TIA (30.9%), and in 22.2% versus 8.3% of those with hemorrhagic stroke (HS, 2%) at baseline. There was no difference in the efficacy of treatment for either the primary end point (LVD hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.49 to 1.02, TIA HR 0.81, CI 0.57 to 1.17, SVD HR 0.85, CI 0.64 to 1.12, unknown cause HR 0.87, CI 0.61 to 1.24, HS HR 3.24, CI 1.01 to 10.4; P for heterogeneity=0.421), or MCVEs (P for heterogeneity=0.360) based on subtype of the index event. As compared to subjects with LVD strokes, those with SVD had similar MCVE rates (19.2% versus 18.5% over the course of the trial), and similar overall reductions in stroke and MCVEs.
conclusionsAtorvastatin 80 mg/d is similarly efficacious in preventing strokes and other cardiovascular events, irrespective of baseline ischemic stroke subtype.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.