Original Article
Long-term Improvement in Outcome After Intracerebral Hemorrhage in Patients Treated with Statins

https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.06.015Get rights and content

Background

Intracerebral hemorrhage (ICH) is a severe type of stroke for which there is currently no specific medical therapy. We hypothesized that statins reduce immediate inflammatory injury and improve long-term recovery from increased neurogenesis and angiogenesis. We conducted a large retrospective cohort study to assess the influence of statin therapy on patient death and disability at 12 months after ICH.

Methods

This was a retrospective analysis of a prospectively collected database at a tertiary care medical center. Patients were grouped based on statin use, and poor outcome was assessed as dead or alive with dependency (modified Barthel Index ≤14).

Results

We compared outcomes in 190 patients exposed to statins to 236 patients who were not exposed to statins. Univariate analysis found that statin use was associated with decreased mortality in-hospital and at 12 months (P = .001). Multivariable analysis found that statin use was associated with a decreased odds of death or disability at 12 months after ICH (odds ratio 0.44; 95% confidence interval 0.21-0.95).

Conclusions

Statin use is associated with improved long-term outcome at 12 months after ICH. This finding supports previous clinical studies that have shown the short-term benefits of statin therapy. In addition, this study correlates with animal studies supporting the possible long-term recovery benefits of statins.

Section snippets

Methods

This was a retrospective analysis of prospectively collected data from the Stroke Center database at a tertiary care medical center. The aim was to investigate the association of statin use on mortality and functional outcomes at 12 months in ICH patients. Subjects 18 years of age or older who were admitted with spontaneous ICH between January 2007 and May 2011 were included. Patients with an ICH secondary to trauma, hemorrhagic conversion of ischemic stroke, tumor, or vascular malformation

Results

Five hundred sixty-two patients were identified as having an ICH during the study period. Of this group, 136 were excluded because of ICH determined to be secondary to an underlying lesion or incomplete medical records, leaving 426 patients for analysis. Of those analyzed, 190 were exposed to a statin and 236 were not. Among the patients who were treated with statins, 50 patients were taking statin medications at home but these were not continued during the hospitalization, 65 had statin

Discussion

The results showed an association of statin use, either at the onset of ICH or during the acute hospitalization, with reduced death and disability at 12 months after ICH. This long-term outcome measure may capture both the early effects of statins on the inflammatory response after ICH and the later effects on mechanisms of repair and recovery.

Despite high rates of death and disability, there is currently no effective specific treatment for ICH. Secondary mechanisms of injury, including

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