title: Previous statin use is not associated with an increased prevalence or degree of gradient-echo lesions in patients with acute ischemic stroke or transient ischemic attack.
abstract: OBJECTIVE
  Microhemorrhages on gradient-echo T2*-weighted MRI sequences are often found in patients with cerebrovascular disease and are related to intracerebral hemorrhage. Because statin therapy is associated with increased risk of intracerebral hemorrhage, we investigated whether statin use was also associated with microhemorrhages in patients with acute ischemic stroke or transient ischemic attack.
  
  
  METHODS
  We performed a retrospective analysis on prospectively collected data from a stroke registry containing patients with acute ischemic stroke or transient ischemic attack. The primary and secondary outcome variables were the prevalence and degree of microhemorrhages as detected on gradient-echo MRI sequences and categorized as mild (1-2), moderate (3-10), or severe (>10). The location of the microhemorrhages was noted and rated by 2 neuroradiologists. Previous use of statins and other covariates were assessed as potential predictors.
  
  
  RESULTS
  Three hundred forty-nine patients were admitted from June 2008 to July 2009, and 300 of which were analyzed. Microhemorrhages were detected in 70 subjects (23%); 35 had only lobar lesions, 16 had only deep lesions, and 19 had both lobar and deep lesions. On univariate and multivariate analysis, statin therapy was not associated with the prevalence (OR, 0.73; 95% CI, 0.36-1.51; P=0.40) or degree of microhemorrhages modeled for lesser severity (OR, 2.31; 95% CI, 0.61-8.75; P=0.22).
  
  
  CONCLUSIONS
  Previous statin therapy was not associated with the prevalence or degree of microhemorrhages in patients with acute ischemic stroke or transient ischemic attack. The association between statins and intracerebral hemorrhage does not appear to be mediated through microhemorrhages.
authors.affiliation: Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA. jason.day@carondelet.com
authors.forename: Jason S
authors.initials: JS
authors.lastname: Day
authors.forename: Bruno A
authors.initials: BA
authors.lastname: Policeni
authors.forename: Wendy R K
authors.initials: WR
authors.lastname: Smoker
authors.forename: Mircea C
authors.initials: MC
authors.lastname: Dobre
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.forename: Enrique C
authors.initials: EC
authors.lastname: Leira
authors.forename: Patricia H
authors.initials: PH
authors.lastname: Davis
authors.forename: Sherman
authors.initials: S
authors.lastname: Chen
authors.forename: Heena
authors.initials: H
authors.lastname: Olalde
authors.forename: Harold P
authors.initials: HP
authors.lastname: Adams
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000139:chemically induced / Q000473:pathology; D017352:Echo-Planar Imaging / Q000379:methods; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D002546:Ischemic Attack, Transient / Q000139:chemically induced / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced / Q000473:pathology*; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors