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Published on: July 3, 2014
Outcomes from intracerebral hemorrhage among patients pre-treated with statins
Flávio Ramalho Romero1, Eduardo de Freitas Bertolini, Vanessa Nogueira Veloso
1Neurosurgery Service, Hospital Ipiranga, SUS, São Paulo SP, Brazil. frromero@ig.com.br
Insights
Pre-ICH statin use did not impact functional independence or mortality in intracerebral hemorrhage (ICH) survivors. This study found no association between statin use before ICH and patient outcomes 90 days post-treatment.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Pharmacology
Background:
- Statins (HMG-CoA reductase inhibitors) are linked to better outcomes in ischemic stroke but may increase intracerebral hemorrhage (ICH) risk.
- The effect of pre-ICH statin use on functional outcomes remains unclear.
Purpose of the Study:
- To investigate the association between pre-ICH statin use and functional independence at 90 days.
- To determine if statin use influences mortality rates in ICH patients.
Main Methods:
- Prospective cohort study of 83 ICH patients with 90-day outcome data.
- Statin usage confirmed via patient interviews and medical records.
- Functional independence defined by Glasgow Outcome Scale (grades 4 or 5).
Main Results:
- 24% (20/83) of patients used statins before ICH onset.
- No significant difference in functional independence rates between statin users (28%) and non-users (29%).
- Mortality rates were similar for both groups (46% vs. 45%).
Conclusions:
- Pre-ICH statin use is not associated with altered functional outcomes.
- Statin use before intracerebral hemorrhage does not appear to affect mortality.
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:
Statins were used by 20 out of 83 patients (24%) before ICH onset. There was no effect from pre-ICH statin use on functional independence rates (28% versus 29%, P=0.84) or mortality (46% versus 45%, P=0.93).
Conclusion:
Pre-ICH statin use is not associated with changes to ICH functional outcome or mortality.
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