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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

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Statin, cholesterol, and sICH after acute ischemic stroke: systematic review and meta-analysis

Changhong Tan1, Xi Liu1, Lijuan Mo1

  • 1Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|July 4, 2019
PubMed

Insights

Prior statin use does not increase the risk of intracranial hemorrhage (ICH) in acute ischemic stroke (AIS) patients. New statin use may decrease the risk of symptomatic ICH, suggesting statins are safe for AIS management.

Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Background:

  • Intracranial hemorrhage (ICH) is a serious complication after acute ischemic stroke (AIS).
  • The role of statin therapy and cholesterol levels in the risk of ICH following AIS remains debated.
  • Understanding these relationships is crucial for optimizing stroke management.

Purpose of the Study:

  • To evaluate the safety of prior and new statin use in relation to the risk of early poststroke ICH in AIS patients.
  • To assess the association between cholesterol levels and ICH risk in this population.
  • To clarify conflicting evidence regarding statin use and ICH in AIS.

Main Methods:

  • A comprehensive meta-analysis was conducted, searching PubMed and Embase databases.
  • Studies investigating the relationship between statin use, cholesterol levels, and early poststroke ICH in AIS were included.
  • A random-effects model was employed to synthesize data from 25 articles involving 26,327 participants.

Main Results:

  • Prior statin use showed no significant association with overall ICH or symptomatic ICH (sICH) in patients receiving thrombolysis.
  • New statin use was significantly associated with a decreased risk of sICH after recanalization therapy (OR, 0.292; P < 0.001).
  • Cholesterol levels were not found to be associated with the risk of overall ICH.

Conclusions:

  • Neither prior nor new statin use, nor lower cholesterol levels, appear to be risk factors for ICH in AIS patients.
  • New statin initiation may be linked to a reduced risk of symptomatic ICH post-stroke.
  • These findings support the continued use of statins in AIS patients, even those undergoing recanalization therapy.
Abstract

Keywords:
CholesterolIntracranial hemorrhageStatinStroke

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