Prehemorrhage statin use and the risk of vasospasm after aneurysmal subarachnoid hemorrhage

Surg Neurol. 2009 Mar;71(3):311-7, discussion 317-8. doi: 10.1016/j.surneu.2007.12.027. Epub 2008 Apr 18.

Abstract

Background and purpose: Aneurysmal SAH is often followed by delayed ischemic deficits attributable to cerebral vasospasm. Recent studies suggest a positive impact of statin therapy on the incidence of vasospasm. This study was designed to assess whether a history of prior use of statin therapy was associated with a lower risk of vasospasm in patients with SAH.

Methods: We performed a comprehensive retrospective review of patients with aneurysmal SAH between 1997 and 2004. Clinical demographics and imaging data for all patients were reviewed, and a logistic regression analysis was performed to identify the predictors of cerebral vasospasm, defined as a combination of clinical signs with radiographic confirmation.

Results: Three hundred eight patients were included. Mean age was higher in the group receiving statins (64 +/- 12 vs 54 +/- 12 years). Hunt and Hess scores and treatment modality were not significantly different between the groups. Vasospasm was observed in 31% of patients not taking a statin (n = 282) vs 23% taking a statin (n = 26), without achieving statistical significance. Discontinuation of the statin did not affect risk of vasospasm.

Conclusions: Use of a statin prior to an aneurysmal SAH trended to reduce the incidence of subsequent vasospasm, without achieving statistical significance.

MeSH terms

  • Adult
  • Aged
  • Brain Ischemia / epidemiology*
  • Brain Ischemia / prevention & control
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Incidence
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Risk Factors
  • Subarachnoid Hemorrhage / epidemiology*
  • Subarachnoid Hemorrhage / surgery
  • Vasospasm, Intracranial / epidemiology*
  • Vasospasm, Intracranial / prevention & control

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors