title: A randomized, double-blind, placebo-controlled pilot study of simvastatin in aneurysmal subarachnoid hemorrhage.
abstract: OBJECTIVE
  Studies suggest statins ameliorate aneurysmal subarachnoid hemorrhage (SAH)-induced cerebral vasospasm and ischemic complications. We tested safety and feasibility of simvastatin 80 mg/d for vasospasm prevention in SAH patients.
  
  
  METHODS
  Thirty-nine statin-naïve Fisher grade 3 SAH subjects were double-blind randomized to receive simvastatin 80 mg/d (n=19) or placebo (n=20), stratified by Hunt and Hess grade. Primary end points were death and drug morbidity.
  
  
  RESULTS
  Mortality was 3/20 in the placebo and 0/19 in the simvastatin group. Study drug was withdrawn in 1 subject in each treatment group for reversible liver enzyme or creatine phosphokinase elevation. Angiographically-confirmed vasospasm occurred in 8/20 placebo and 5/19 simvastatin-treated subjects. Vasospasm-related ischemic infarcts developed in 5/20 placebo and 2/19 simvastatin-treated subjects.
  
  
  CONCLUSIONS
  Simvastatin for the prevention of delayed cerebral ischemia is safe and feasible after SAH. A larger study is needed to test its efficacy.
authors.forename: Sherry H-Y
authors.initials: SH
authors.lastname: Chou
authors.forename: Eric E
authors.initials: EE
authors.lastname: Smith
authors.forename: Neeraj
authors.initials: N
authors.lastname: Badjatia
authors.forename: Raul G
authors.initials: RG
authors.lastname: Nogueira
authors.forename: John R
authors.initials: JR
authors.lastname: Sims
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ogilvy
authors.forename: Guy A
authors.initials: GA
authors.lastname: Rordorf
authors.forename: Cenk
authors.initials: C
authors.lastname: Ayata
mesh_terms: D004311:Double-Blind Method; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019821:Simvastatin / Q000627:therapeutic use*; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000188:drug therapy*; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000517:prevention & control*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin