title: Effects of atorvastatin on plasma matrix metalloproteinase-9 concentration after glial tumor resection; a randomized, double blind, placebo controlled trial.
abstract: BACKGROUND
  Neurosurgical procedures such as craniotomy and brain tumor resection could potentially lead to unavoidable cerebral injuries. Matrix metalloproteinase-9 (MMP-9) is up-regulated in neurological injuries. Statins have been suggested to reduce MMP- 9 level and lead to neuroprotection. Atorvastatin preoperatively administered to evaluate its neuroprotective effects and outcome assessment in neurosurgical-induced brain injuries after glial tumor resection. In this prospective, randomized, double-blind, placebo-controlled trial, 42 patients undergoing glial tumor surgery randomly received 40 mg atorvastatin or placebo twice daily from seven days prior to operation and continued for a 3 weeks period. Plasma MMP-9 concentration measured 4 times, immediately before starting atorvastatin or placebo, immediately before surgery, 24 hours and two weeks after the surgery. Karnofsky performance score was assessed before first dose of atorvastatin as a baseline and 2 months after the surgery.
  
  
  RESULTS
  Karnofsky performance scale after surgery raised significantly more in Atorvastatin group (11.43 +/- 10.62 vs. 4.00 +/- 8.21) (p = 0.03). Atorvastatin did not significantly reduce MMP-9 plasma concentration 24 hours after surgery in comparison to placebo. No statistical significance detected regarding length of hospital stay among the groups. Significant reduction in MMP-9 plasma concentration was recorded in atorvastatin group two weeks after surgery (p = 0.048).
  
  
  CONCLUSIONS
  Significant statistical differences detected with atorvastatin group regarding MMP-9 plasma concentration, clinical outcome and Karnofsky performance score. Consequently, atorvastatin use may lead to better outcome after neurosurgical procedures.
authors.forename: Niayesh
authors.initials: N
authors.lastname: Mohebbi
authors.forename: Alireza
authors.initials: A
authors.lastname: Khoshnevisan
authors.forename: Soheil
authors.initials: S
authors.lastname: Naderi
authors.forename: Sina
authors.initials: S
authors.lastname: Abdollahzade
authors.forename: Jamshid
authors.initials: J
authors.lastname: Salamzadeh
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Javadi
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Mojtahedzadeh
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. khgholami@tums.ac.ir.
authors.forename: Kheirollah
authors.initials: K
authors.lastname: Gholami