Statin use and outcome after intracerebral hemorrhage: case-control study and meta-analysis.

Abstract:

OBJECTIVES: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 We therefore performed a meta-analysis of all available evidence, including unpublished data from our own institution, to determine whether statin exposure is protective for patients who develop ICH.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. CONCLUSION: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.

journal_name

Neurology

journal_title

Neurology

authors

Biffi A,Devan WJ,Anderson CD,Ayres AM,Schwab K,Cortellini L,Viswanathan A,Rost NS,Smith EE,Goldstein JN,Greenberg SM,Rosand J

doi

10.1212/WNL.0b013e3182194be9

subject

Has Abstract

pub_date

2011-05-03 00:00:00

pages

1581-8

issue

18

eissn

0028-3878

issn

1526-632X

pii

WNL.0b013e3182194be9

journal_volume

76

pub_type

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