title: High-Dose Simvastatin Is Effective in Preventing Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study in Korean Patients.
abstract: OBJECTIVE
  The goal of this study was to assess the effect of high-dose simvastatin on cerebral vasospasm and its clinical outcome after aneurysmal subarachnoid hemorrhage (SAH) in Korean patients.
  
  
  METHODS
  This study was designed as a prospective observational cohort study. Its subjects were aneurysmal SAH patients who had undergone aneurysm clipping or coiling. They were assigned to 1 of 3 groups : the 20 mg, 40 mg, and 80 mg simvastatin groups. The primary end-point was the occurrence of symptomatic vasospasm. The clinical outcome was assessed with the modified Rankin Scale (mRS) score after 1 month and 3 months. The risk factors of the development of vasospasm were assessed by logistic regression analysis.
  
  
  RESULTS
  Ninety nine patients with aneurysmal SAH were treated and screened. They were sequentially assigned to the 20 mg (n=22), 40 mg (n=34), and 80 mg (n=31) simvastatin groups. Symptomatic vasospasm occurred in 36.4% of the 20 mg group, 8.8% of the 40 mg group, and 3.2% of the 80 mg group (p=0.003). The multiple logistic regression analysis showed that poor Hunt-Hess grades (OR=5.4 and 95% CI=1.09-26.62) and high-dose (80 mg) simvastatin (OR=0.09 and 95% CI=0.1-0.85) were independent factors of symptomatic vasospasm. The clinical outcomes did not show a significant difference among the three groups.
  
  
  CONCLUSIONS
  This study demonstrated that 80 mg simvastatin treatment was effective in preventing cerebral vasospasm after aneurysmal SAH, but did not improve the clinical outcome in Korean patients.
authors.affiliation: Department of Neurosurgery, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Sung Woong
authors.initials: SW
authors.lastname: Woo
authors.affiliation: Department of Neurosurgery, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Hee In
authors.initials: HI
authors.lastname: Kang
authors.affiliation: Department of Neurosurgery, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Deok Ryeong
authors.initials: DR
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Byung Gwan
authors.initials: BG
authors.lastname: Moon
authors.affiliation: Department of Neurosurgery, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Joo Seung
authors.initials: JS
authors.lastname: Kim
keywords: Outcome; Statin; Subarachnoid hemorrhage; Vasospasm