Impact of Statins on Hematoma, Edema, Seizures, Vascular Events, and Functional Recovery After Intracerebral Hemorrhage
| Autor: | Hajo M. Hamer, Jan F. Scheitz, Hannes Lücking, Christian H. Nolte, Stefanie Balk, Hagen B. Huttner, Stefan T. Gerner, Andrea Rocco, Bastian Volbers, Philip Hölter, Maximilian I. Sprügel, Matthias Endres, Justina I. Saam, Jochen A. Sembill, Joji B. Kuramatsu |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
epidemiology [Cerebral Hemorrhage] drug therapy [Hematoma] Hematoma Seizures Edema therapeutic use [Hydroxymethylglutaryl-CoA Reductase Inhibitors] medicine Humans odds ratio In patient cardiovascular diseases ddc:610 Prospective Studies Cerebral Hemorrhage Aged seizures Advanced and Specialized Nursing Intracerebral hemorrhage Aged 80 and over drug therapy [Cerebral Hemorrhage] business.industry drug therapy [Edema] Incidence (epidemiology) hematoma Odds ratio Middle Aged medicine.disease Functional recovery Treatment Outcome drug therapy [Seizures] Anesthesia incidence Regression Analysis Female Neurology (clinical) medicine.symptom Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business edema |
| Zdroj: | Stroke 52(3), 975-984 (2021). doi:10.1161/STROKEAHA.120.029345 |
| DOI: | 10.1161/STROKEAHA.120.029345 |
| Popis: | Background and Purpose: The impact of statins on hematoma characteristics, perihemorrhagic edema (PHE), cardiovascular events, seizures, and functional recovery in patients with intracerebral hemorrhage (ICH) is insufficiently studied. Methods: Patients with ICH of the prospective UKER-ICH (Universitätsklinikum Erlangen Cohort of Patients With Spontaneous Intracerebral Hemorrhage) study (URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03183167) were analyzed by multivariable regression modeling and propensity score matching, and PHE volumes were volumetrically assessed. Outcomes comprised hematoma characteristics, the impact of continuation, discontinuation, and initiation of statins on peak PHE extent, and the influence of statin treatment on the occurrence of seizures, cardiovascular adverse events, and functional recovery after ICH. Results: A total of 1275 patients with ICH with information on statin treatment were analyzed. Statin treatment on hospital admission (21.7%) was associated with higher rates of lobar versus nonlobar ICH (odds ratio, 1.57 [1.03–2.40]; P =0.038). Initiation of statins after ICH was associated with increased peak PHE (β=0.12, SE=0.06, P =0.008), whereas continuation versus discontinuation of prior statin treatment was not significantly associated with edema formation ( P >0.10). There were no significant differences in the incidence of remote symptomatic seizures according to statin exposure during follow-up (statins: 11.5% versus no statins: 7.8%, subdistribution hazard ratio: 1.15 [0.80–1.66]; P =0.512). Patients on statins revealed less cardiovascular adverse events and more frequently functional recovery after 12 months (functional recovery: 57.7% versus 45.0%, odds ratio 1.67 [1.09–2.56]; P =0.019). Conclusions: Among statin users, lobar ICH occurs more frequently as compared with nonstatin users. While continuation of prior statin treatment appears to be safe regarding PHE formation, the initiation of statins during the first days after ICH may increase PHE extent. However, statins should be initiated thereafter (eg, at hospital discharge) to prevent cardiovascular events and potentially improve functional recovery. |
| Databáze: | OpenAIRE |
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