Prehemorrhage statin use and the risk of vasospasm after aneurysmal subarachnoid hemorrhage.
OBJECTIVE
Aneurysmal SAH is often followed by delayed ischemic deficits attributable to cerebral vasospasm. Recent studies suggest a positive impact of statin therapy on the incidence of vasospasm. This study was designed to assess whether a history of prior use of statin therapy was associated with a lower risk of vasospasm in patients with SAH.


METHODS
We performed a comprehensive retrospective review of patients with aneurysmal SAH between 1997 and 2004. Clinical demographics and imaging data for all patients were reviewed, and a logistic regression analysis was performed to identify the predictors of cerebral vasospasm, defined as a combination of clinical signs with radiographic confirmation.


RESULTS
Three hundred eight patients were included. Mean age was higher in the group receiving statins (64 +/- 12 vs 54 +/- 12 years). Hunt and Hess scores and treatment modality were not significantly different between the groups. Vasospasm was observed in 31% of patients not taking a statin (n = 282) vs 23% taking a statin (n = 26), without achieving statistical significance. Discontinuation of the statin did not affect risk of vasospasm.


CONCLUSIONS
Use of a statin prior to an aneurysmal SAH trended to reduce the incidence of subsequent vasospasm, without achieving statistical significance.
Moskowitz
Shaye I
SI
Department of Neurosurgery, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. moskows@ccf.org
Ahrens
Christine
C
Provencio
J Javier
JJ
Chow
Michael
M
Rasmussen
Peter A
PA
D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000601:surgery; D020301:Vasospasm, Intracranial / Q000453:epidemiology* / Q000517:prevention & control
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors