[Perioperative intensive statin therapy improves outcomes in patients with ischemic stroke undergoing middle cerebral artery stent implantation]
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Updated: Mar 22, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Ju-Hua Gao1, Xiao-Ping Gao, Su-Yue Pan
1Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail: gaojh406@126.com.
Insights
Intensive statin therapy before and after middle cerebral artery stent implantation for stroke significantly reduced inflammatory markers and major adverse cerebrovascular events. This approach improves patient outcomes following stent procedures.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Pharmacology
Background:
- Ischemic stroke poses a significant health burden, necessitating effective interventions.
- Middle cerebral artery (MCA) stent implantation is a procedure used to treat ischemic stroke.
- Perioperative management strategies are crucial for optimizing outcomes after MCA stent implantation.
Purpose of the Study:
- To evaluate the efficacy of intensive perioperative statin therapy in patients undergoing MCA stent implantation.
- To assess the impact of intensive statin therapy on inflammatory markers and clinical outcomes.
- To determine if high-dose statin therapy reduces the incidence of major adverse cerebrovascular events.
Main Methods:
- A randomized controlled trial involving 40 patients with ischemic stroke undergoing MCA stent implantation.
- Patients were assigned to either an intensive statin group (atorvastatin 80 mg/day) or a standard therapy group (atorvastatin 20 mg/day) perioperatively.
- Serum levels of C-reactive protein (CRP), vascular cell adhesion molecule-1 (VCAM-1), and soluble extracellular matrix metalloproteinase inducer (sCD147) were measured before and after the intervention.
Main Results:
- The intensive statin group showed significantly lower postoperative levels of CRP, VCAM-1, and sCD147 compared to the standard therapy group.
- Inflammatory markers increased post-intervention in the standard therapy group.
- The incidence of primary endpoints, including intra-stent thrombosis and major adverse cerebrovascular events, was significantly lower in the intensive statin group.
Conclusions:
- Perioperative intensive statin therapy enhances outcomes in patients undergoing MCA stent implantation for ischemic stroke.
- Intensive statin therapy effectively reduces key inflammatory markers (CRP, VCAM-1, sCD147).
- This therapeutic approach lowers the incidence of cerebrovascular events, improving patient safety and recovery.
Objective:
To investigate whether intensive statin therapy during the perioperative period improves outcomes in patients undergoing middle cerebral artery (MCA) stent implantation for ischemic stroke.
Methods:
Forty patients with ischemic stroke undergoing delayed stent implantation in our department from January, 2010 to November, 2014 were randomized to intensive statin group (atorvastatin, 80 mg/day, 3 days before till 3 days after intervention; n=20) and standard therapy group (atorvastatin, 20 mg/day, n=20). All the patients received long-term atorvastatin treatment thereafter (20 mg/day). Serum levels of C-reactive protein (CRP), vascular cell adhesion molecule-1 (VCAM-1), and soluble extracellular matrix metalloproteinase inducer (EMMPRIN/CD147) were measured at 24 h before and 24 h after the intervention. The primary end point was procedure-related intra-stent thrombosis, 1-month incidence of major adverse cerebrovascular events (stroke, transient ischemic attack, in-stent restenosis, death or unplanned revascularization).
Results:
The basic clinical data were similar between the two groups before the intervention (P>0.05). In the intensive therapy group, the levels of CRP, VCAM-1, and sCD147 were significantly lower at 24 h after the intervention than the levels before intervention (P<0.05) and the postoperative levels in the standard therapy group (P<0.05). The levels of CRP, VCAM-1, and sCD147 were all increased after the intervention in the standard therapy group (P>0.05). The incidence of primary end point was lower in intensive therapy group than in standard therapy group (P<0.05).
Conclusion:
In patients undergoing MCA intravascular stent implantation for ischemic stroke, perioperative intensive statin therapy improves the patients' outcomes, reduces the levels of CRP, VCAM-1 and sCD147 molecules, and lowers the incidences of cerebrovascular events.
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