Pre–Intracerebral Hemorrhage and In-Hospital Statin Use in Intracerebral Hemorrhage: A Systematic Review and Meta-analysis

Publication date: March 2018
Source:World Neurosurgery, Volume 111
Author(s): Chunyan Lei, Tao Chen, Chun Chen, Yifan Ling
BackgroundThe association between pre–intracerebral hemorrhage (ICH) statin use and clinical outcomes after intracerebral hemorrhage (ICH) is still conflicting. Recently, some studies investigating the effects of in-hospital statin use after the onset of ICH have been published. To provide a more complete picture of the clinical effects of statin use in ICH, we performed a systematic review to examine whether statin use influences clinical outcomes.MethodsWe conducted a systematic review of literature in the Cochrane Library, MEDLINE, EMBASE, and the China National Knowledge Infrastructure database.ResultsTwenty-one studies were included in our systematic review. Meta-analysis of 12 studies suggested that pre-ICH statins use did not significantly decrease mortality when aggregated across all time points tested—that is, in-hospital or at 30 or 90 days (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.70–1.03). Meta-analysis of 7 studies suggested that pre-ICH statins use did not significantly affect poor functional outcomes, defined as a modified Rankin Scale (mRS) score of 3–6 (OR, 0.93; 95% CI, 0.72–1.18) or mRS score of 4–6 (OR, 0.92; 95% CI, 0.60–1.40). Meta-analysis of 7 studies suggested that in-hospital statin use significantly decreased mortality when aggregated across all time points tested (OR, 0.37; 95% CI, 0.28–0.50). Statin discontinuation was independently associated with poor clinical outcome.ConclusionsThe patients with pre-ICH statin use did not improve clinical outcomes. However, in-hospital statin use can significantly decrease mortality after ICH. In-hospital statin therapy might be beneficial for patients with ICH.



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