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Erschienen in: Neurocritical Care 2/2011

01.10.2011 | Review

Summary of Evidence on Immediate Statins Therapy Following Aneurysmal Subarachnoid Hemorrhage

verfasst von: M. Y. Tseng, The Participants in the International Multidisciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage

Erschienen in: Neurocritical Care | Ausgabe 2/2011

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Abstract

Statins were shown to have neuroprotective effects, with reduced vasospasm and delayed ischemic deficits in statin-treated patients after aneurysmal subarachnoid hemorrhage in two small, randomized, controlled clinical trials published in 2005. This review consolidated data from available published studies evaluating statin treatment for subarachnoid hemorrhage. A literature search was conducted to identify original research studies published through October 2010 testing immediate treatment with a statin in statin-naïve patients following aneurysmal SAH. Six randomized controlled clinical trials and four observational studies were identified. Despite inconsistent results among studies, a meta-analysis of randomized controlled data showed a significant reduction in delayed ischemic deficits with statins. Effect on vasospasm was more difficult to determine, due to differences in definitions used among studies. Interpretations from observational studies were limited by the use of relatively small sample sizes, historical controls, and treatment variability.
Literatur
1.
Zurück zum Zitat Bederson JB, Connolly ES Jr, Batjer HH, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 2009;40:994–1025.PubMedCrossRef Bederson JB, Connolly ES Jr, Batjer HH, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 2009;40:994–1025.PubMedCrossRef
2.
Zurück zum Zitat Sabri M, Macdonald RL. Statins: a potential therapeutic addition to treatment for aneurysmal subarachnoid hemorrhage? World Neurosurg. 2010;73:646–53.PubMedCrossRef Sabri M, Macdonald RL. Statins: a potential therapeutic addition to treatment for aneurysmal subarachnoid hemorrhage? World Neurosurg. 2010;73:646–53.PubMedCrossRef
3.
Zurück zum Zitat Tseng M, Czosnyka M, Richards H, Pickard JD, Kirkpatrick PJ. Effects of acute treatment with pravastatin on cerebral vasospasm, autoregulation, and delayed ischemic deficits after aneurysmal subarachnoid hemorrhage: a phase II randomized placebo-controlled trial. Stroke. 2005;36:1627–32.PubMedCrossRef Tseng M, Czosnyka M, Richards H, Pickard JD, Kirkpatrick PJ. Effects of acute treatment with pravastatin on cerebral vasospasm, autoregulation, and delayed ischemic deficits after aneurysmal subarachnoid hemorrhage: a phase II randomized placebo-controlled trial. Stroke. 2005;36:1627–32.PubMedCrossRef
4.
Zurück zum Zitat Lynch JR, Wang H, McGirt MJ, et al. Simvastatin reduces vasospasm after aneurysmal subarachnoid hemorrhage. Stroke. 2005;36:2024–6.PubMedCrossRef Lynch JR, Wang H, McGirt MJ, et al. Simvastatin reduces vasospasm after aneurysmal subarachnoid hemorrhage. Stroke. 2005;36:2024–6.PubMedCrossRef
5.
Zurück zum Zitat Vergouwen MD, de Haan RJ, Vermeulen M, Roos YB. Effect of statin treatment on vasospasm, delayed cerebral ischemia, and functional outcome in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis update. Stroke. 2010;41:e47–52.PubMedCrossRef Vergouwen MD, de Haan RJ, Vermeulen M, Roos YB. Effect of statin treatment on vasospasm, delayed cerebral ischemia, and functional outcome in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis update. Stroke. 2010;41:e47–52.PubMedCrossRef
6.
Zurück zum Zitat Kramer AH, Fletcher JJ. Statins in the management of patients with aneurysmal subarachnoid hemorrhage: a systemic review and meta-analysis. Neurocrit Care. 2010;12:285–96.PubMedCrossRef Kramer AH, Fletcher JJ. Statins in the management of patients with aneurysmal subarachnoid hemorrhage: a systemic review and meta-analysis. Neurocrit Care. 2010;12:285–96.PubMedCrossRef
7.
Zurück zum Zitat Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490.PubMedCrossRef Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490.PubMedCrossRef
8.
Zurück zum Zitat Chou SH, Smith EE, Badjatia N, et al. A randomized, double-blind, placebo-controlled pilot study of simvastatin in aneurysmal subarachnoid hemorrhage. Stroke. 2008;39:2891–3.PubMedCrossRef Chou SH, Smith EE, Badjatia N, et al. A randomized, double-blind, placebo-controlled pilot study of simvastatin in aneurysmal subarachnoid hemorrhage. Stroke. 2008;39:2891–3.PubMedCrossRef
9.
Zurück zum Zitat Vergouwen M, Meijers J, Geskus RB, et al. Biological effects of simvastatin in patients with aneurysmal subarachnoid hemorrhage: a double-blind, placebo-controlled randomized trial. J Cereb Blood Flow Metab. 2009;29:1444–53.PubMedCrossRef Vergouwen M, Meijers J, Geskus RB, et al. Biological effects of simvastatin in patients with aneurysmal subarachnoid hemorrhage: a double-blind, placebo-controlled randomized trial. J Cereb Blood Flow Metab. 2009;29:1444–53.PubMedCrossRef
10.
Zurück zum Zitat Jaschinski U, Scherer K, Lichtwarck M, Forst H. Impact of treatment with pravastatin on delayed ischemic disease and mortality after aneurysmal subarachnoid hemorrhage. Critical Care. 2008;12(Suppl 2):P112.CrossRef Jaschinski U, Scherer K, Lichtwarck M, Forst H. Impact of treatment with pravastatin on delayed ischemic disease and mortality after aneurysmal subarachnoid hemorrhage. Critical Care. 2008;12(Suppl 2):P112.CrossRef
11.
Zurück zum Zitat Macedo S, Belio Y, Siqueria C, Siqueria S, Brito L. Effects of simvastatin in prevention of vasospasm in nontraumatic subarachnoid hemorrhage: preliminary data. Critical Care. 2009;13(Suppl 1):P103.CrossRef Macedo S, Belio Y, Siqueria C, Siqueria S, Brito L. Effects of simvastatin in prevention of vasospasm in nontraumatic subarachnoid hemorrhage: preliminary data. Critical Care. 2009;13(Suppl 1):P103.CrossRef
12.
Zurück zum Zitat Kramer AH, Gurka MJ, Nathan B, Dumont AS, Kassell NF, Bleck TP. Statin use was not associated with less vasospasm or improved outcome after subarachnoid hemorrhage. Neurosurgery. 2008;62:422–7.PubMedCrossRef Kramer AH, Gurka MJ, Nathan B, Dumont AS, Kassell NF, Bleck TP. Statin use was not associated with less vasospasm or improved outcome after subarachnoid hemorrhage. Neurosurgery. 2008;62:422–7.PubMedCrossRef
13.
Zurück zum Zitat McGirt MJ, Garces Ambrossi GL, Huang J, Tamargo RJ. Simvastatin for the prevention of symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage: a single-institution prospective cohort study. J Neurosurg. 2009;110:968–74.PubMedCrossRef McGirt MJ, Garces Ambrossi GL, Huang J, Tamargo RJ. Simvastatin for the prevention of symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage: a single-institution prospective cohort study. J Neurosurg. 2009;110:968–74.PubMedCrossRef
14.
Zurück zum Zitat Kern M, Lam MM, Knuckey NW, Lind CR. Statins may not protect against vasospasm in subarachnoid hemorrhage. J Clin Neurosci. 2009;16:527–30.PubMedCrossRef Kern M, Lam MM, Knuckey NW, Lind CR. Statins may not protect against vasospasm in subarachnoid hemorrhage. J Clin Neurosci. 2009;16:527–30.PubMedCrossRef
15.
Zurück zum Zitat Kerz T, Victor A, Beyer C, Trapp I, Heid F, Reisch R. A case control study of statin and magnesium administration in patients after aneurysmal subarachnoid hemorrhage: incidence of delayed cerebral ischemia and mortality. Neurol Res. 2008;30:893–7.PubMedCrossRef Kerz T, Victor A, Beyer C, Trapp I, Heid F, Reisch R. A case control study of statin and magnesium administration in patients after aneurysmal subarachnoid hemorrhage: incidence of delayed cerebral ischemia and mortality. Neurol Res. 2008;30:893–7.PubMedCrossRef
Metadaten
Titel
Summary of Evidence on Immediate Statins Therapy Following Aneurysmal Subarachnoid Hemorrhage
verfasst von
M. Y. Tseng
The Participants in the International Multidisciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage
Publikationsdatum
01.10.2011
Verlag
Humana Press Inc
Erschienen in
Neurocritical Care / Ausgabe 2/2011
Print ISSN: 1541-6933
Elektronische ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-011-9596-6

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