Volume 12 Supplement 2
Impact of treatment with pravastatin on delayed ischemic disease and mortality after aneurysmal subarachnoid hemorrhage
© BioMed Central Ltd 2008
Published: 13 March 2008
Statins have neuroprotective properties including improved vasomotor reactivity, reduced platelet activation and anti-inflammatory effects . A prospective observational controlled study was conducted to evaluate the impact of pravastatin on the development of delayed ischemic disease (DID) and ICU mortality after aneurysmal subarachnoid hemorrhage (aSAH).
A total of 98 patients (20–80 years old) with aSAH were randomized to receive either pravastatin 40 mg (n = 40) or nonstatin treatment (n = 58) within 24 hours after the ictus. Primary endpoints, incidence of DID and extent of disability measured by the Glasgow Outcome Scale; secondary endpoint, ICU mortality.
Groups were comparable with respect to age (54.2 (50.3–58.3) vs 53.2 (49.8–56.7) 95% CI), grade of aSAH (Hess/Hunt) (2.6 (2.17–3.03) vs 3.06 (3.00–3.80) 95% CI) and stroke severity (Glasgow Coma Scale 10.9 (9.4–12.4) vs 10.5 (9.3–11.8) 95% CI). There was a trend towards less DID in the statin group (37.5% vs 60.3% nonstatin; standard error of the difference of the means 9.8 (3.64–28.00) 95% CI). The extent of disability between the groups, however, was not different (Glasgow Outcome Scale 3.65 (3.16–4.14) statin vs 3.39 (3.00–3.80) nonstatin 95% CI). Mortality was unchanged as well (22.5% statin vs 22.4% nonstatin).
These results are in line with a recently published study demonstrating reduced vasospasm-related DID in patients treated with pravastatin after aSAH . We could not confirm the benefit of statin treatment regarding mortality as mentioned in the cited trial since our study was not powered to detect a difference in mortality. So it is to be hoped that the Statins for Aneurysmal Hemorrhage STASH trial will clarify this topic.
This article is published under license to BioMed Central Ltd.