Research Paper Volume 12, Issue 3 pp 2939—2951

Atorvastatin reduces cerebral vasospasm and infarction after aneurysmal subarachnoid hemorrhage in elderly Chinese adults

Junhui Chen 1, 2, *, , Mingchang Li 1, *, , Xun Zhu 2, , Lei Chen 2, , Shuo Yang 2, , Chunlei Zhang 2, , Ting Wu 3, , Xiaoyan Feng 2, , Yuhai Wang 2, , Qianxue Chen 1, ,

  • 1 Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
  • 2 Department of Neurosurgery, Wuxi Clinical College of Anhui Medical University, 904th Hospital of Joint Logistic Support Force of PLA, Wuxi 214044, China
  • 3 Department of Cardiology, Wuxi Clinical College of Anhui Medical University, 904th Hospital of Joint Logistic Support Force of PLA, Wuxi 214044, China
* Equal contribution

received: October 11, 2019 ; accepted: January 19, 2020 ; published: February 7, 2020 ;

https://doi.org/10.18632/aging.102788
How to Cite

Copyright © 2020 Chen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

We explored whether acute atorvastatin treatment would improve clinical outcomes and reduce the incidence of cerebral vasospasm after aneurysmal subarachnoid hemorrhage in elderly Chinese adults. Patients (60 to 90 years old) were admitted to intensive care units after surgery to clip or embolize their aneurysms. We assessed 592 patients and assigned 159 to receive atorvastatin (20 mg/day) and 158 to receive placebo once daily for up to 14 days. The primary outcome was the Glasgow outcome scale at 6 months, and secondary outcomes were cerebral vasospasm, 30-days all-cause mortality, cerebral infarction, and delayed ischemic neurological deficit. The incidence of postoperative cerebral vasospasm (39.3% vs 56%, P =0.004) and cerebral infarction (18.7% vs 27.3%, P=0.027) were significantly lower in the atorvastatin group. The study did not detect benefits in the use of atorvastatin for 6 months clinical outcome or 30-day all-cause mortality, but it suggests that atorvastatin together with nimodipine can reduce cerebral vasospasm and cerebral infarction after subarachnoid hemorrhage.

Abbreviations

CT: computed tomography; CTA: computed tomography angiography; CTP: computed tomography perfusion; SAH: subarachnoid hemorrhage; CVS: cerebral vasospasm; GOS: Glasgow outcome scale; RCT: randomized, placebo-controlled trial; DCI: delayed cerebral ischemia; DSA: digital subtraction angiography; TCD: Transcranial Dopple; DIND: delayed ischemic neurological deficit; ADL: activities of daily living.