title: Perihematoma cerebral blood flow is unaffected by statin use in acute intracerebral hemorrhage patients.
abstract: Statin therapy has been associated with improved cerebral blood flow (CBF) and decreased perihematoma edema in animal models of intracerebral hemorrhage (ICH). We aimed to assess the relationship between statin use and cerebral hemodynamics in ICH patients. A post hoc analysis of 73 ICH patients enrolled in the Intracerebral Hemorrhage Acutely Decreasing Arterial Pressure Trial (ICH ADAPT). Patients presenting <24 hours from ICH onset were randomized to a systolic blood pressure target <150 or <180 mm Hg with computed tomography perfusion imaging 2 hours after randomization. Cerebral blood flow maps were calculated. Hematoma and edema volumes were measured planimetrically. Regression models were used to assess the relationship between statin use, perihematoma edema and cerebral hemodynamics. Fourteen patients (19%) were taking statins at the time of ICH. Statin-treated patients had similar median (IQR Q25 to 75) hematoma volumes (21.1 (9.5 to 38.3) mL versus 14.5 (5.6 to 27.7) mL, P=0.25), but larger median (IQR Q25 to 75) perihematoma edema volumes (2.9 (1.7 to 9.0) mL versus 2.2 (0.8 to 3.5) mL, P=0.02) compared with nontreated patients. Perihematoma and ipsilateral hemispheric CBF were similar in both groups. A multivariate linear regression model revealed that statin use and hematoma volumes were independent predictors of acute edema volumes. Statin use does not affect CBF in ICH patients. Statin use, along with hematoma volume, are independently associated with increased perihematoma edema volume.
authors.affiliation: Division of Neurology, 2E3 WMC Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Gioia
authors.affiliation: Division of Neurology, 2E3 WMC Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Kate
authors.affiliation: Division of Neurology, 2E3 WMC Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: McCourt
authors.affiliation: Division of Neurology, 2E3 WMC Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Bronwen
authors.initials: B
authors.lastname: Gould
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Shelagh B
authors.initials: SB
authors.lastname: Coutts
authors.affiliation: Division of Neurology, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Dariush
authors.initials: D
authors.lastname: Dowlatshahi
authors.affiliation: Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Negar
authors.initials: N
authors.lastname: Asdaghi
authors.affiliation: Division of Neurology, 2E3 WMC Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Thomas
authors.initials: T
authors.lastname: Jeerakathil
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Demchuk
authors.affiliation: Division of Neurology, 2E3 WMC Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Buck
authors.affiliation: Department of Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Derek
authors.initials: D
authors.lastname: Emery
authors.affiliation: Division of Neurology, 2E3 WMC Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Shuaib
authors.affiliation: Division of Neurology, 2E3 WMC Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Butcher
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D005260:Female; D006406:Hematoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging; D014057:Tomography, X-Ray Computed
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors