Prior Statin Use, Intracranial Hemorrhage, and Outcome After Intra-Arterial Thrombolysis for Acute Ischemic Stroke

Abstract

Background and Purpose-There are only limited data on whether prior statin use and/or cholesterol levels are associated with intracranial hemorrhage (ICH) and outcome after intra-arterial thrombolysis. The purpose of this study was to evaluate the association of statin pretreatment and cholesterol levels with the overall frequency of ICH, the frequency of symptomatic ICH, and clinical outcome at 3 months. Methods-We analyzed 311 consecutive patients (mean age, 63 years; 43% women) who received intra-arterial thrombolysis. Results-Statin pretreatment was present in 18%.

Statins May Increase Intracerebral Hemorrhage Volume

“…HMG-CoA reductase inhibitors were also associated with a higher frequency of ICH after intra-arterial thrombolysis but without any impact on outcome. 22 All these observations about mortality are consistent with ours and the SPARCL subgroup analysis, in which no difference was demonstrated in the rate of fatal hemorrhagic strokes with statin agents. 7 We also showed that the increase in ICH volume among statin users was significant in lobar and infratentorial ICH but not in basal ganglia ICH.…”

Interventional Stroke Therapies in the Elderly: Are We Helping?

“…Therapies including IA tPA, clot retrieval devices, and combination therapies with IV tPA have been shown to improve revascularization rates and stroke outcomes up to 6 hours after the onset of stroke in younger patients. [8][9][10][11][12] The higher incidence of amyloid angiopathy, 13 decreased tPA clearance, 14 difficult vascular access, polypharmacy, blood-brain barrier impairment, 15 and age-related alterations in coagulation 16,17 has raised concerns of increased complications, mainly SICH, which are associated with increased mortality and disability, 18,19 when applying these treatments to the elderly. The objective of this study was to assess the complication rates and functional outcomes in older patients treated with endovascular techniques.…”

Serum Lipids and Statin Treatment During Acute Stroke

“…On the other hand, no increase of bleeding was observed as well. Meier et al [2009] in a monocenter study of 311 consecutive patients, of whom 18% were statin pretreated, found a higher rate of intracerebral bleeding among statin users (OR 3.1, P=0.004). This fact was unrelated to the 90 day functional and neurological outcome.…”