Combination of Thrombolysis and Statins in Acute Stroke Is Safe Results of the STARS Randomized Trial (Stroke Treatment With Acute Reperfusion and Simvastatin)
| Autor: | Montaner, J, Bustamante, A, Garcia-Matas, S, Martinez-Zabaleta, M, Jimenez, C, de la Torre, J, Rubio, FR, Segura, T, Masjuan, J, Canovas, D, Freijo, M, Delgado-Mederos, R, Tejada, J, Lago, A, Bravo, Y, Corbeto, N, Giralt, D, Vives-Pastor, B, de Arce, A, Moniche, F, Delgado, P, Ribo, M, STARS Investigators |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Simvastatin medicine.medical_specialty thrombolysis medicine.medical_treatment 030204 cardiovascular system & hematology Placebo Brain Ischemia law.invention 03 medical and health sciences 0302 clinical medicine Double-Blind Method Fibrinolytic Agents Randomized controlled trial Modified Rankin Scale law Internal medicine Outcome Assessment Health Care medicine Humans simvastatin Stroke Aged Aged 80 and over Advanced and Specialized Nursing business.industry clinical trial Thrombolysis Odds ratio Middle Aged medicine.disease stroke Surgery Clinical trial Tissue Plasminogen Activator Drug Therapy Combination Female neuroprotection Neurology (clinical) Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Stroke r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname STROKE r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
| ISSN: | 0039-2499 |
| Popis: | Background and Purpose— The STARS trial (Stroke Treatment With Acute Reperfusion and Simvastatin) was conducted to demonstrate the efficacy and safety of simvastatin treatment in acute stroke. Methods— STARS07 was a multicentre, phase IV, prospective, randomized, double-blind, placebo-controlled trial. Patients with Acute ischemic stroke recruited within 12 hours from symptom onset were randomized to oral simvastatin 40 mg or placebo, once daily for 90 days. Primary outcome was proportion of independent patients (modified Rankin Scale score of ≤2) at 90 days. Safety end points were hemorrhagic transformation, hemorrhagic events, death, infections, and serious adverse events. Results— From April 2009 to March 2014, 104 patients were included. Fifty-five patients received intravenous tissue-type plasminogen activator. No differences were found between treatment arms regarding the primary outcome (adjusted odds ratio, 0.99 [0.35–2.78]; P =0.98). Concerning safety, no significant differences were found in the rate of hemorrhagic transformation of any type, nor symptomatic hemorrhagic transformation. There were no differences in other predefined safety outcomes. In post hoc analyses, for patients receiving tissue-type plasminogen activator, a favorable effect for simvastatin treatment was noted with higher proportion of patients experiencing major neurological recovery (adjusted odds ratio, 4.14 [1.18–14.4]; P =0.02). Conclusions— Simvastatin plus tissue-type plasminogen activator combination seems safe in acute stroke, with low rates of bleeding complications. Because of the low recruitment, the STARS trial was underpowered to detect differences in simvastatin efficacy. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01073007. |
| Databáze: | OpenAIRE |
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