Article
Meta-analysis of statins in the acute phase of spontaneous intracerebral hemorrhage
Search Medline for
Authors
-
Jorge Humberto Tapia Pérez
- Klinik für Neurochirurgie, Universitätsklinikum Otto von Guericke, Magdeburg
-
Omer Chan Yildiz
- Klinik für Neurochirurgie, Universitätsklinikum Otto von Guericke, Magdeburg
-
Thomas Schneider
- Klinik für Neurochirurgie, Universitätsklinikum Otto von Guericke, Magdeburg
| Published: | June 2, 2015 |
|---|
Outline
Text
Objective: Growing evidence demonstrates the neuroprotective effects of statins and the risk to develop an intracerebral hemorrhage (ICH) by taking statin has been refuted. However some controversy remains respect their role in the acute phase after ICH onset. Therefore we performed a systematic review to investigate this issue.
Method: We searched in MEDLINE, Web of Knowledge, and Scopus databases for studies examining the outcome in patients with spontaneous ICH and statin use. The analysis was performed for short outcome (<3 months) and long-term outcome (>6 months) and a further sub-analysis considered studies seeking for the discontinuation of statin after ICH onset. A random effect model was applied and country was used as cofactor for meta-regression; odds ratios (OR) with 95% confidence intervals are offered.
Results: A total of 16 studies were included, only one pseudo cohort trial assessed the new use of statin after ICH-onset and 3 studies evaluated the suspension of statin after ICH onset. The rest of studies focused on the effect of the regular use of statin before ICH onset. An own dataset with 301 patients was included. The amount of patients with an ICH exposed to statins were 3455 and non-users 11821. The absolute mortality was 27.3% in statin users and 33% in non-users. The meta-analysis of these patients showed a significant risk reduction on short-term mortality (OR 0.73; 0.54-0.97). For long-term mortality the effect was lower. The analysis of the 3 studies assessing the discontinuation of statins suggested a risk reduction of mortality by continuing statins (OR 0.14; 0.1-0.20).
Conclusions: The current evidence suggests that continuing statin after ICH onset might be highly related to improvement on the outcome of patients with ICH. Despite this strong suggestion, randomized controlled trials should be performed.
