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document
Effects of statins on progression of subclinical brain infarct . BACKGROUND Subclinical brain infarct ( SBI ) is associated with subsequent stroke and cognitive decline . A longitudinal epidemiological study suggests that statins may prevent development of SBI . We investigated the effects of statins upon development of brain infarct by performing a post-hoc analysis of the Regression of Cerebral Artery Stenosis ( ROCAS ) study . METHODS The ROCAS study is a randomized , double-blind , placebo-controlled study evaluating the effects of simvastatin 20 mg daily upon progression of asymptomatic middle cerebral artery stenosis among stroke-free individuals over 2 years . A total of 227 subjects were randomized to either placebo ( n = 114 ) or simvastatin 20 mg daily ( n = 113 ) . The number of brain infarcts as detected by MRI was recorded at baseline and at the end of the study . The primary outcome measure was the number of new brain infarcts at the end of the study . RESULTS Among the 227 randomized subjects , 33 ( 14.5 % ) had SBI at baseline . At the end of the study , significantly fewer subjects in the active group ( n = 1 ) had new brain infarcts compared with the placebo group ( n = 8 ; p = 0.018 ) . The new brain infarcts of subjects in the active group were subclinical . Among the placebo group , the new brain infarcts of 3 subjects were symptomatic while those of the remaining 5 subjects were subclinical . Among putative variables , multivariate regression analysis showed that only the baseline number of SBIs ( OR = 6.27 , 95 % CI 2.4-16.5 ) and simvastatin treatment ( OR = 0.09 , 95 % CI 0.01-0.82 ) independently predicted the development of new brain infarcts . CONCLUSIONS Consistent with findings of the epidemiological study , our study suggests that statins may prevent the development of a new brain infarct .
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Intervention_Pharmacological
statins
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Intervention_Pharmacological
statins
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Intervention_Pharmacological
statins
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Intervention_Pharmacological
simvastatin
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Intervention_Control
placebo
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Intervention_Pharmacological
simvastatin
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Intervention_Control
placebo
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Intervention_Control
placebo
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Intervention_Pharmacological
simvastatin
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Outcome_Physical
subclinical brain infarct
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Outcome_Physical
Subclinical brain infarct ( SBI )
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Outcome_Physical
SBI
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Outcome_Physical
development of brain infarct
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Outcome_Physical
number of brain infarcts
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Outcome_Physical
number of new brain infarcts
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Outcome_Physical
new brain infarcts
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Outcome_Physical
brain infarcts
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Outcome_Physical
brain infarcts
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Outcome_Physical
SBIs
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Outcome_Physical
brain infarct
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Participant_Condition
stroke-free individuals over 2 years .
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Participant_Condition
total of 227 subjects
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Participant_Condition
227 randomized subjects , 33 ( 14.5 % ) had SBI at baseline .