Preadmission statin use does not improve functional outcomes or prevent delayed ischemic events in patients with spontaneous subarachnoid hemorrhage

Bryan D. Lizza*, Adam Kosteva, Matthew B. Maas, Neil F. Rosenberg, Eric Liotta, James Guth, Kimberly E. Levasseur-Franklin, Andrew M. Naidech

*Corresponding author for this work

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Study Objective To determine whether preadmission statin use in patients with spontaneous subarachnoid hemorrhage (SAH) is associated with improved functional outcomes and a lower incidence of delayed cerebral ischemic events compared with statin-naive patients with SAH. Design Prospective cohort study. Setting Neurosciences intensive care unit of a tertiary care hospital. Patients A total of 295 consecutive patients with SAH admitted between March 2006 and May 2013 who had complete medication histories; of these patients, 41 reported taking a statin prior to admission, and 254 were statin naive. Intervention All patients received clinical management for SAH according to hospital protocol for standard care that included acute statin therapy with enteral pravastatin 40 mg/day on hospital day 1 for up to 21 days. Measurements and Main Results Functional outcomes were assessed by using the modified Rankin Scale (mRS) at 14 days, 28 days, and 3 months. Delayed cerebral ischemia was assessed by using clinical evaluation and computed tomography. Patients taking statins prior to admission were more likely to have a history of diabetes mellitus, hypertension, coronary artery disease, and stroke. No significant difference in favorable neurologic outcome (mRS score 0-3) at 3 months was observed between the preadmission statin group compared with the statin-naive group (56.3% vs 72.4%, p=0.095). In multivariate logistic regression analysis, only age, severity of rupture, and coronary artery disease were less likely to predict a favorable neurologic outcome. No significant difference in the development of delayed cerebral ischemic events was observed between groups (p=0.48). Conclusion Statin use prior to admission did not improve functional outcomes or prevent delayed cerebral ischemic events in patients with SAH. Age, severity of rupture, and coronary artery disease were less likely to predict a favorable neurologic outcome at 3 months after discharge.

Original languageEnglish (US)
Pages (from-to)811-817
Number of pages7
JournalPharmacotherapy
Volume34
Issue number8
DOIs
StatePublished - Aug 2014

Keywords

  • functional outcome
  • ischemia
  • statin
  • subarachnoid hemorrhage
  • vasospasm

ASJC Scopus subject areas

  • Pharmacology (medical)

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