Outcomes from intracerebral hemorrhage among patients pre-treated with statins

Abstract

Objective: 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins, have been associated with improved clinical outcomes after ischemic stroke and subarachnoid hemorrhage, but with an increased risk of incidental spontaneous intracerebral hemorrhage (ICH). We investigated whether the statin use before ICH, was associated with functional independence, 90 days after treatment. Method: We analyzed 124 consecutive ICH patients with 90-day outcome data who were enrolled in a prospective cohort study between 2006 and 2009. Eighty-three patients were included in this study. Among ICH survivors, univariate Cox regression models and Kaplan-Meier plots were used to determine subject characteristics that were associated with an increased risk of recurrence. Statin usage was determined through interviewing the patient at the time of ICH and confirmed by reviewing their medical records. Independent status was defined as Glasgow Outcome Scale grades 4 or 5. Results: Were stain users 20/83 (24%) patients before the ICH. There was no effect from pre-ICH statin use on the functional independence rates (32% versus 36%, P=0.79) or mortality (41% versus 47%, P=0.82). Conclusion: Pre-ICH statin use is not associated with changes to ICH functional outcome or mortality.

Association of Prestroke Statin Use and Lipid Levels With Outcome of Intracerebral Hemorrhage

“…[12][13][14] The statin users were older, had more frequent comorbidities and prior disabilities compared with nonusers in our study, unlike in earlier studies where the statin users have both achieved better outcomes and have been less disabled. 5,6 Statin therapy has been recommended to be avoided in some patients with a high risk of ICH, as in amyloid angiopathy where quality-adjusted life-year gain has been reported in patients avoiding statins.…”

Association between statin use and intracerebral hemorrhage: a systematic review and meta‐analysis

“…in‐hospital or at 30 or 90 days post‐discharge (OR 0.85, 95% CI 0.70–1.03; Fig. ) . A similar effect was observed when separate analyses were performed for mortality in‐hospital (OR 1.00, 95% CI 0.84–1.20; Fig.…”

“…However, pre-ICH statin use significantly decreased 90-day mortality (OR 0.72, 95% CI 0.59-0.88; Fig. 3c) [1,2,4,13,14,18,19].…”

“…The 12 studies of pre-ICH statin use and ICH involved 1652 participants in the favors pre-ICH statin group and 5309 in the favors no pre-ICH statin group [1][2][3][4][5]10,[13][14][15][16][17][18][19]. The basic characteristics of the included studies were summarized in Table 1.…”

“…No study reported blinded assessment of the MRS. Only two studies reported the proportion of patients who were followed up. Six studies were classified as prospective cohort [1][2][3]5,14,18], and another six as retrospective cohort [4,10,13,15,17,19].…”