High-Dose Simvastatin Is Effective in Preventing Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study in Korean Patients.
10.3340/jkns.2015.58.4.328
- Author:
Sung Woong WOO
1
;
Jae Hoon KIM
;
Hee In KANG
;
Deok Ryeong KIM
;
Byung Gwan MOON
;
Joo Seung KIM
Author Information
1. Department of Neurosurgery, Eulji University School of Medicine, Seoul, Korea. grimi2@hanmail.net
- Publication Type:Original Article
- Keywords:
Outcome;
Statin;
Subarachnoid hemorrhage;
Vasospasm
- MeSH:
Aneurysm*;
Cohort Studies*;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Logistic Models;
Prospective Studies*;
Risk Factors;
Simvastatin*;
Subarachnoid Hemorrhage*;
Vasospasm, Intracranial*
- From:Journal of Korean Neurosurgical Society
2015;58(4):328-333
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The goal of this study was to assess the effect of high-dose simvastatin on cerebral vasospasm and its clinical outcome after aneurysmal subarachnoid hemorrhage (SAH) in Korean patients. METHODS: This study was designed as a prospective observational cohort study. Its subjects were aneurysmal SAH patients who had undergone aneurysm clipping or coiling. They were assigned to 1 of 3 groups : the 20 mg, 40 mg, and 80 mg simvastatin groups. The primary end-point was the occurrence of symptomatic vasospasm. The clinical outcome was assessed with the modified Rankin Scale (mRS) score after 1 month and 3 months. The risk factors of the development of vasospasm were assessed by logistic regression analysis. RESULTS: Ninety nine patients with aneurysmal SAH were treated and screened. They were sequentially assigned to the 20 mg (n=22), 40 mg (n=34), and 80 mg (n=31) simvastatin groups. Symptomatic vasospasm occurred in 36.4% of the 20 mg group, 8.8% of the 40 mg group, and 3.2% of the 80 mg group (p=0.003). The multiple logistic regression analysis showed that poor Hunt-Hess grades (OR=5.4 and 95% CI=1.09-26.62) and high-dose (80 mg) simvastatin (OR=0.09 and 95% CI=0.1-0.85) were independent factors of symptomatic vasospasm. The clinical outcomes did not show a significant difference among the three groups. CONCLUSION: This study demonstrated that 80 mg simvastatin treatment was effective in preventing cerebral vasospasm after aneurysmal SAH, but did not improve the clinical outcome in Korean patients.
