Medizinische Universität Graz - Research portal

Go directly to the nagivation.
Go directly to the content.

Navigation/Search

Selected Publication:

SHR Neuro Cancer Cardio Lipid Metab Microb

Prats-Sanchez, L; Camps-Renom, P; Nash, PS; Wilson, D; Ambler, G; Best, JG; Guasch-Jiménez, M; Ramos-Pachón, A; Martinez-Domeño, A; Lambea-Gil, Á; Díaz, GE; Guisado-Alonso, D; Du, H; Al-Shahi, Salman, R; Jäger, HR; Lip, GY; Ay, H; Jung, S; Bornstein, NM; Gattringer, T; Eppinger, S; van, Dam-Nolen, DH; Koga, M; Toyoda, K; Fluri, F; Phan, TG; Srikanth, VK; Heo, JH; Bae, HJ; Kelly, PJ; Imaizumi, T; Staals, J; Köhler, S; Yakushiji, Y; Orken, DN; Smith, EE; Wardlaw, JM; Chappell, FM; Makin, SD; Mas, JL; Calvet, D; Bordet, R; Chen, CP; Veltkamp, R; Kandiah, N; Simister, RJ; De, Leeuw, FE; Engelter, ST; Peters, N; Soo, YO; Zietz, A; Hendrikse, J; Mess, WH; Werring, DJ; Marti-Fabregas, J.
Statin Therapy for Secondary Prevention in Ischemic Stroke Patients With Cerebral Microbleeds.
Neurology. 2024; 102(7): e209173 Doi: 10.1212/WNL.0000000000209173
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Eppinger Sebastian; Gattringer Thomas
Altmetrics:
Dimensions Citations:
Plum Analytics:
Scite (citation analytics):
Abstract:: BACKGROUND AND OBJECTIVES: The association between statin use and the risk of intracranial hemorrhage (ICrH) following ischemic stroke (IS) or transient ischemic attack (TIA) in patients with cerebral microbleeds (CMBs) remains uncertain. This study investigated the risk of recurrent IS and ICrH in patients receiving statins based on the presence of CMBs. METHODS: We conducted a pooled analysis of individual patient data from the Microbleeds International Collaborative Network, comprising 32 hospital-based prospective studies fulfilling the following criteria: adult patients with IS or TIA, availability of appropriate baseline MRI for CMB quantification and distribution, registration of statin use after the index stroke, and collection of stroke event data during a follow-up period of ≥3 months. The primary endpoint was the occurrence of recurrent symptomatic stroke (IS or ICrH), while secondary endpoints included IS alone or ICrH alone. We calculated incidence rates and performed Cox regression analyses adjusting for age, sex, hypertension, atrial fibrillation, previous stroke, and use of antiplatelet or anticoagulant drugs to explore the association between statin use and stroke events during follow-up in patients with CMBs. RESULTS: In total, 16,373 patients were included (mean age 70.5 ± 12.8 years; 42.5% female). Among them, 10,812 received statins at discharge, and 4,668 had 1 or more CMBs. The median follow-up duration was 1.34 years (interquartile range: 0.32-2.44). In patients with CMBs, statin users were compared with nonusers. Compared with nonusers, statin therapy was associated with a reduced risk of any stroke (incidence rate [IR] 53 vs 79 per 1,000 patient-years, adjusted hazard ratio [aHR] 0.68 [95% CI 0.56-0.84]), a reduced risk of IS (IR 39 vs 65 per 1,000 patient-years, aHR 0.65 [95% CI 0.51-0.82]), and no association with the risk of ICrH (IR 11 vs 16 per 1,000 patient-years, aHR 0.73 [95% CI 0.46-1.15]). The results in aHR remained consistent when considering anatomical distribution and high burden (≥5) of CMBs. DISCUSSION: These observational data suggest that secondary stroke prevention with statins in patients with IS or TIA and CMBs is associated with a lower risk of any stroke or IS without an increased risk of ICrH. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with IS or TIA and CMBs, statins lower the risk of any stroke or IS without increasing the risk of ICrH.
Find related publications in this database (using NLM MeSH Indexing): Humans - administration & dosage; Female - administration & dosage; Middle Aged - administration & dosage; Aged - administration & dosage; Aged, 80 and over - administration & dosage; Male - administration & dosage; Ischemic Attack, Transient - epidemiology; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Cerebral Hemorrhage - epidemiology; Ischemic Stroke - complications; Prospective Studies - administration & dosage; Secondary Prevention - administration & dosage; Neoplasm Recurrence, Local - complications; Stroke - epidemiology; Intracranial Hemorrhages - complications; Magnetic Resonance Imaging - administration & dosage; Cerebral Infarction - complications; Risk Factors - administration & dosage