Impact of Statins on Hematoma, Edema, Seizures, Vascular Events, and Functional Recovery After Intracerebral Hemorrhage
Sprügel M, Kuramatsu J, Volbers B, Saam J, Sembill J, Gerner S, Balk S, Hamer H, Lücking H, Hölter P, Nolte CH, Scheitz JF, Rocco A, Endres M, Huttner H (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 52
Pages Range: 975-984
Journal Issue: 3
DOI: 10.1161/STROKEAHA.120.029345
Abstract
BACKGROUND AND PURPOSE: The impact of statins on hematoma characteristics, perihemorrhagic edema (PHE), cardiovascular events, seizures, and functional recovery in patients with intracerebral hemorrhage (ICH) is insufficiently studied. METHODS: Patients with ICH of the prospective UKER-ICH (Universitätsklinikum Erlangen Cohort of Patients With Spontaneous Intracerebral Hemorrhage) study (URL: https://www.clinicaltrials.gov; Unique identifier: NCT03183167) were analyzed by multivariable regression modeling and propensity score matching, and PHE volumes were volumetrically assessed. Outcomes comprised hematoma characteristics, the impact of continuation, discontinuation, and initiation of statins on peak PHE extent, and the influence of statin treatment on the occurrence of seizures, cardiovascular adverse events, and functional recovery after ICH. RESULTS: A total of 1275 patients with ICH with information on statin treatment were analyzed. Statin treatment on hospital admission (21.7%) was associated with higher rates of lobar versus nonlobar ICH (odds ratio, 1.57 [1.03-2.40]; P=0.038). Initiation of statins after ICH was associated with increased peak PHE (β=0.12, SE=0.06, P=0.008), whereas continuation versus discontinuation of prior statin treatment was not significantly associated with edema formation (P>0.10). There were no significant differences in the incidence of remote symptomatic seizures according to statin exposure during follow-up (statins: 11.5% versus no statins: 7.8%, subdistribution hazard ratio: 1.15 [0.80-1.66]; P=0.512). Patients on statins revealed less cardiovascular adverse events and more frequently functional recovery after 12 months (functional recovery: 57.7% versus 45.0%, odds ratio 1.67 [1.09-2.56]; P=0.019). CONCLUSIONS: Among statin users, lobar ICH occurs more frequently as compared with nonstatin users. While continuation of prior statin treatment appears to be safe regarding PHE formation, the initiation of statins during the first days after ICH may increase PHE extent. However, statins should be initiated thereafter (eg, at hospital discharge) to prevent cardiovascular events and potentially improve functional recovery.
Authors with CRIS profile
Maximilian Sprügel
Department of Neurology
Joji Kuramatsu
Medizinische Fakultät
Bastian Volbers
Department of Neurology
Justina Saam
Department of Neurology
Jochen Sembill
Department of Neurology
Stefan Gerner
Department of Neurology
Stefanie Balk
Department of Neurology
Hajo Hamer
Professur für Epileptologie
Hannes Lücking
Department of Neuroradiology
Philip Hölter
Department of Neuroradiology
Hagen Huttner
Medizinische Fakultät
Involved external institutions
Germany (DE)How to cite
APA:
Sprügel, M., Kuramatsu, J., Volbers, B., Saam, J., Sembill, J., Gerner, S.,... Huttner, H. (2021). Impact of Statins on Hematoma, Edema, Seizures, Vascular Events, and Functional Recovery After Intracerebral Hemorrhage. Stroke, 52(3), 975-984. https://doi.org/10.1161/STROKEAHA.120.029345
MLA:
Sprügel, Maximilian, et al. "Impact of Statins on Hematoma, Edema, Seizures, Vascular Events, and Functional Recovery After Intracerebral Hemorrhage." Stroke 52.3 (2021): 975-984.
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