Original ArticleLong-term Improvement in Outcome After Intracerebral Hemorrhage in Patients Treated with 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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2023, Brain HemorrhagesCitation Excerpt :Prior studies have indicated several mechanisms by which statins can affect the brain biomarkers after stroke and brain injury including phosphorylation and stimulation of phosphatidylinositol-3 kinase (PI3K)/ Akt signaling pathway, activation of the Notch pathway, and increasing the nitric oxide synthesis.18–20. Several observational and retrospective investigations in humans have reported that patients who were on statins following ICH had better functional outcomes and lower mortality rates.21–24 However, prospective studies regarding the beneficial effect of statin treatment in acute ICH are lacking.
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2022, Journal of Stroke and Cerebrovascular DiseasesCitation Excerpt :Several pre-clinical and clinical studies focusing on the effects of different neuroprotective agents on improving the outcome of ICH have been conducted. Clinical trials have been conducted for NXY-059, deferoxamine, minocycline, statins, CN-105, celecoxib, intravenous immunoglobulin (IVIG), magnesium sulfate, and Sphingosine 1 Phosphate Receptor Modulators (fingolimod and siponimod).29–43 Although most of these agents were shown to have good safety and tolerance, they mostly failed to demonstrate any benefit in patients with ICH.
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2021, World NeurosurgeryCitation Excerpt :The use of statins in human ICH has been minimally assessed with no large prospective trials evaluating the safety and efficacy of statins in this patient population. Studies, including SPARCL, have indicated an increase in risk of ICH after statin use after retrospective review.7,8 However, multiple cohort studies, meta-analyses, and retrospective database studies have analyzed the use of statins in ICH and found varying results with some studies finding reduced morbidity and mortality and others finding poor functional recovery related to statins.36-45
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2018, World NeurosurgeryCitation Excerpt :Five studies were conducted in United States,11,15,20,26,32 with 3 in Canada,14,21,28 2 in Taiwan,19,31 2 in Israel,12, 22 and 1 each in China,29 England,16 Spain,13 Singapore,23 Japan,24 Finland,25 Brazil,27 Mexico,30 and Germany.33 Among 21 studies, 6 were based on retrospective cohorts,15,20,24,27,28,33 5 were based on prospective cohorts,11,13,19,26,30 1 was based on a combined prospective and retrospective cohort,31 and 9 involved registry data.12-14,16,22,23,25,29,32 In one study, the risk of selection bias was minimized by recruitment from a community-dwelling population.19
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