title: Statin use and outcome after intracerebral hemorrhage: case-control study and meta-analysis.
abstract: OBJECTIVE
  Intracerebral hemorrhage (ICH) is a highly lethal disease of the elderly. Use of statins is increasingly widespread among the elderly, and therefore common in patients who develop ICH. Accumulating data suggests that statins have neuroprotective effects, but their association with ICH outcome has been inconsistent. We therefore performed a meta-analysis of all available evidence, including unpublished data from our own institution, to determine whether statin exposure is protective for patients who develop ICH.
  
  
  METHODS
  In our prospectively ascertained cohort, we compared 90-day functional outcome in 238 pre-ICH statin cases and 461 statin-free ICH cases. We then meta-analyzed results from our cohort along with previously published studies using a random effects model, for a total of 698 ICH statin cases and 1,823 non-statin-exposed subjects.
  
  
  RESULTS
  Data from our center demonstrated an association between statin use before ICH and increased probability of favorable outcome (odds ratio [OR] = 2.08, 95% confidence interval [CI] 1.37-3.17) and reduced mortality (OR = 0.47, 95% CI 0.32-0.70) at 90 days. No compound-specific statin effect was identified. Meta-analysis of all published evidence confirmed the effect of statin use on good outcome (OR = 1.91, 95% CI 1.38-2.65) and mortality (OR = 0.55, 95% CI 0.42-0.72) after ICH.
  
  
  CONCLUSIONS
  Antecedent use of statins prior to ICH is associated with favorable outcome and reduced mortality after ICH. This phenomenon appears to be a class effect of statins. Further studies are required to clarify the biological mechanisms underlying these observations.
authors: Center for Human Genetic Research, Massachusetts General Hospital, 185 Cambridge Street, CPZN-6818, Boston, MA 02114, USA.
authors: A
authors: A
authors: Biffi
authors: W J
authors: WJ
authors: Devan
authors: C D
authors: CD
authors: Anderson
authors: A M
authors: AM
authors: Ayres
authors: K
authors: K
authors: Schwab
authors: L
authors: L
authors: Cortellini
authors: A
authors: A
authors: Viswanathan
authors: N S
authors: NS
authors: Rost
authors: E E
authors: EE
authors: Smith
authors: J N
authors: JN
authors: Goldstein
authors: S M
authors: SM
authors: Greenberg
authors: J
authors: J
authors: Rosand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000401:mortality*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors