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Statin therapy and the risk of intracerebral hemorrhage: a meta-analysis of 31 randomized controlled trials

James S McKinney1, William J Kostis

  • 1Cardiovascular Institute of New Jersey and the Department of Neurology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA. mckinnjs@umdnj.edu

Stroke
|May 17, 2012
PubMed

Insights

Statin therapy does not increase the risk of intracerebral hemorrhage (ICH). This meta-analysis found statins significantly reduce total stroke and all-cause mortality, confirming their safety and efficacy.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Pharmacology

Background:

  • Statin therapy is known to reduce ischemic stroke risk.
  • Some studies suggest a potential increased risk of intracerebral hemorrhage (ICH) with statin use.
  • This meta-analysis addresses the safety concerns regarding statins and ICH.

Purpose of the Study:

  • To evaluate the association between statin therapy and the risk of intracerebral hemorrhage (ICH).
  • To synthesize evidence from randomized controlled trials (RCTs) reporting ICH events.
  • To assess the overall impact of statins on stroke and mortality outcomes.

Main Methods:

  • Comprehensive literature search of major databases (Medline, Web of Science, Cochrane Library) through January 2012.
  • Inclusion of 31 randomized controlled trials (RCTs) that reported ICH or hemorrhagic stroke.
  • Random effects models used for analysis; heterogeneity was not observed.

Main Results:

  • No significant difference in ICH incidence between statin and control groups (OR, 1.08; P=0.47).
  • ICH risk was independent of low-density lipoprotein (LDL) reduction or achieved LDL levels.
  • Significant reductions observed in total stroke (OR, 0.84; P<0.0001) and all-cause mortality (OR, 0.92; P=0.0007) with statin therapy.

Conclusions:

  • Statin therapy is not associated with an increased risk of intracerebral hemorrhage (ICH).
  • The findings support the use of statins for reducing overall stroke incidence and all-cause mortality.
  • This meta-analysis provides robust evidence for the safety and efficacy of statin therapy.
Abstract

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