Impact of treatment with pravastatin on delayed ischemic disease and mortality after aneurysmal subarachnoid hemorrhage

Jaschinski, Ulrich; Scherer, K.; Lichtwarck, M.; Forst, H.

doi:10.1186/cc6333

Cited by 16 publications

(36 citation statements)

References 2 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of these 17 studies included in the meta-analysis, 5 were concerned with the biological effects of statins, 5 were controlled trials that enrolled 930 patients to study clinical efficacy, and 7 were RCTs that enrolled 347 patients and that met the inclusion criteria (2,4,7,13,14,23,25).…”

Section: Zhang Bf Et Al: Statins For Aneurysmal Subarachnoid Hemorrhagementioning

confidence: 99%

“…Seven studies were published between 2005 and 2013, most of which had small sample size. In 7 of the studies included in this analysis, 2 (7,23) administered pravastatin or placebo to 178 participates, and 5 (2, 4, 13, 14, 25) administered simvastatin or placebo to 169 patients.…”

Section: Characteristics Of Included Trials and Quality Evaluationmentioning

confidence: 99%

“…Figure 1 shows the risk of bias for included studies, and Figure 2 represents the overall bias of every study aspect. Five trials (2,4,13,23,25) were randomized, double-blind, placebo-controlled trials; 2 trials (7,14) were randomized only in the choice of statin or nonstatin treatment, without a blinding method. Four trials (2,13,23,25) included an intention-to-treat analysis.…”

Section: Characteristics Of Included Trials and Quality Evaluationmentioning

confidence: 99%

“…Two RCTs defined CVS on TCD as mean flow velocities >120 cm/s with a Lindegaard ratio (LR) >3 in MCA (23,25); another 2 RCTs defined CVS as velocities >160 cm/s (4, 13); 1 RCT chose velocities >200 cm/s with LR >3 (2); and 2 RCTs did not report on the definition (7,14). Because it differs from a more objective indicator, CVS on TCD could have influenced the judgment of patient outcomes.…”

Section: Zhang Bf Et Al: Statins For Aneurysmal Subarachnoid Hemorrhagementioning

confidence: 99%

See 3 more Smart Citations

Effect of statins on aneurysmal subarachnoid hemorrhage: a meta-analysis of randomized controlled trials

Zhang¹,

Song²,

Wang³

et al. 2014

Turkish Neurosurgery

View full text Add to dashboard Cite

AIm:The role of statins for treating aneurysmal subarachnoid hemorrhage (aSAH) remains uncertain. In this study, the relevance of different end points was evaluated in order to clarify the action and efficacy of statins. mAterIAl and methOds: A systematic literature retrieval was carried out to obtain randomized controlled trials (RCTs) from before March 2013 on the use of statins for aSAH. Data extraction and quality evaluation of the studies were performed by 2 investigators. A meta-analysis was performed using Review Manager (RevMan) software version 5.2.3. results:Seven randomized controlled trials comprising 347 patients that met the inclusion criteria were included in this meta-analysis. Results showed that, in aSAH, statins did not reduce vasospasm on transcranial Doppler (RR=0.80; 95% CI, 0.53-1.21; p=0.29) or improve outcomes (RR=0.92; 95% CI, 0.71-1.20; p=0.54). However, statins were able to decrease delayed ischemic neurological deficits (RR=0.56; 95% CI, 0.41-0.75; p=0.0001) and mortality (RR=0.54; 95% CI, 0.32-0.91; p=0.02) compared with placebo.COnClusIOn: Acute statin treatment might not be a good choice for cerebral vasospasm after aSAH. Further large-scale, well-designed RCTs on this topic are still needed. BulGulAr: Bu meta analize çalışmaya alma kriterlerini karşılayan 347 hastalık yedi randomize kontrollü çalışma dahil edilmiştir. Sonuçlar aSAK durumunda statinlerin transkraniyal Doppler'de vazospazmı azaltmadığını (RR=0,80; %95 GA, 0,21; p=0,29) veya sonuçları daha iyi hale getirmediğini (RR=0,92; %95CI, 0,20; p=0,54) göstermiştir. Ancak statinler plaseboyla karşılaştırıldığında gecikmiş iskemik nörolojik defisitleri (RR=0,56; %95 GA, 0,41-0,75; p=0,0001) ve mortaliteyi (RR=0,54; %95 GA, 0,32-0,91; p=0,02) azaltmıştır. sOnuÇ: Akut statin tedavisi aSAK sonrasında serebral vazospazm için iyi bir tercih olmayabilir. Bu konuda daha büyük ölçekli ve iyi tasarlanmış randomize kontrollü çalışmalar gereklidir.

show abstract

Section: Zhang Bf Et Al: Statins For Aneurysmal Subarachnoid Hemorrhagementioning

confidence: 99%

Section: Characteristics Of Included Trials and Quality Evaluationmentioning

confidence: 99%

Section: Characteristics Of Included Trials and Quality Evaluationmentioning

confidence: 99%

Section: Zhang Bf Et Al: Statins For Aneurysmal Subarachnoid Hemorrhagementioning

confidence: 99%

See 2 more Smart Citations

Effect of statins on aneurysmal subarachnoid hemorrhage: a meta-analysis of randomized controlled trials

Zhang¹,

Song²,

Wang³

et al. 2014

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…Multiple retrospective studies, and 6 small, prospective, randomized controlled studies (4 of which were published in peer-reviewed journals, 2 of which were published as abstracts) investigated the use of statins in aSAH [88][89][90][91][92][93]. Study results were inconsistent.…”

Section: Statinsmentioning

confidence: 99%