title: [Perioperative intensive statin therapy improves outcomes in patients with ischemic stroke undergoing middle cerebral artery stent implantation].
abstract: OBJECTIVE
  To investigate whether intensive statin therapy during the perioperative period improves outcomes in patients undergoing middle cerebral artery (MCA) stent implantation for ischemic stroke.
  
  
  METHODS
  Forty patients with ischemic stroke undergoing delayed stent implantation in our department from January, 2010 to November, 2014 were randomized to intensive statin group (atorvastatin, 80 mg/day, 3 days before till 3 days after intervention; n=20) and standard therapy group (atorvastatin, 20 mg/day, n=20). All the patients received long-term atorvastatin treatment thereafter (20 mg/day). Serum levels of C-reactive protein (CRP), vascular cell adhesion molecule-1 (VCAM-1), and soluble extracellular matrix metalloproteinase inducer (EMMPRIN/CD147) were measured at 24 h before and 24 h after the intervention. The primary end point was procedure-related intra-stent thrombosis, 1-month incidence of major adverse cerebrovascular events (stroke, transient ischemic attack, in-stent restenosis, death or unplanned revascularization).
  
  
  RESULTS
  The basic clinical data were similar between the two groups before the intervention (P>0.05). In the intensive therapy group, the levels of CRP, VCAM-1, and sCD147 were significantly lower at 24 h after the intervention than the levels before intervention (P<0.05) and the postoperative levels in the standard therapy group (P<0.05). The levels of CRP, VCAM-1, and sCD147 were all increased after the intervention in the standard therapy group (P>0.05). The incidence of primary end point was lower in intensive therapy group than in standard therapy group (P<0.05).
  
  
  CONCLUSIONS
  In patients undergoing MCA intravascular stent implantation for ischemic stroke, perioperative intensive statin therapy improves the patients' outcomes, reduces the levels of CRP, VCAM-1 and sCD147 molecules, and lowers the incidences of cerebrovascular events.
authors.affiliation: Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail: gaojh406@126.com.
authors.forename: Ju-Hua
authors.initials: JH
authors.lastname: Gao
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Gao
authors.forename: Su-Yue
authors.initials: SY
authors.lastname: Pan
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D000069059:Atorvastatin / Q000627:therapeutic use*; D051926:Basigin / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D020768:Middle Cerebral Artery / Q000601:surgery*; D015607:Stents; D020521:Stroke / Q000188:drug therapy*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: C497886:BSG protein, human; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019010:Vascular Cell Adhesion Molecule-1; D051926:Basigin; D002097:C-Reactive Protein; D000069059:Atorvastatin