Effect and Safety of Rosuvastatin in Acute Ischemic Stroke
Background and Purpose The benefit of statins in acute stroke remains uncertain. Statins may prevent stroke recurrence during the acute stage of stroke via pleiotropic effects. However, statins may increase the risk of intracerebral hemorrhage. We investigated the effect and safety of rosuvastatin i...
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doaj-bc9f454e1f7c4d5692c64de48014a4392020-11-25T04:06:18ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052016-01-01181879510.5853/jos.2015.01578118Effect and Safety of Rosuvastatin in Acute Ischemic StrokeJi Hoe Heo0Dongbeom Song1Hyo Suk Nam2Eung Yeop Kim3Young Dae Kim4Kyung-Yul Lee5Ki-Jeong Lee6Joonsang Yoo7Youn Nam Kim8Byung Chul Lee9Byung-Woo Yoon10Jong S. Kim11 Department of Neurology, Yonsei University College of Medicine, Seoul, Korea Department of Neurology, Yonsei University College of Medicine, Seoul, Korea Department of Neurology, Yonsei University College of Medicine, Seoul, Korea Department of Radiology, Gachon University, Gil Medical Center, Incheon, Korea Department of Neurology, Yonsei University College of Medicine, Seoul, Korea Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Neurology, Yonsei University College of Medicine, Seoul, Korea Department of Neurology, Yonsei University College of Medicine, Seoul, Korea Clinical Trials Center, Severance Hospital, Yonsei University Health System, Seoul, Korea Department of Neurology, Hallym University Sacred Heart Hospital, Pyeongchon, Korea Department of Neurology, Seoul National University College of Medicine, Seoul, Korea Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, KoreaBackground and Purpose The benefit of statins in acute stroke remains uncertain. Statins may prevent stroke recurrence during the acute stage of stroke via pleiotropic effects. However, statins may increase the risk of intracerebral hemorrhage. We investigated the effect and safety of rosuvastatin in acute stroke patients. Methods This randomized, double-blind, multi-center trial compared rosuvastatin 20 mg and placebo in statin-naïve stroke patients who underwent diffusion-weighted imaging (DWI) within 48 hours after symptom onset. The primary outcome was occurrence of new ischemic lesions on DWI at 5 or 14 days. Results This trial was stopped early after randomization of 316 patients due to slow enrollment. Among 289 patients with at least one follow-up imaging, the frequency of new ischemic lesions on DWI was not different between groups (rosuvastatin: 27/137, 19.7% vs. placebo: 36/152, 23.6%) (relative risk 0.83, 95% confidence interval 0.53–1.30). Infarct volume growth at 5 days (log-transformed volume change, rosuvastatin: 0.2±1.0 mm3 vs. placebo: 0.3±1.3 mm3; P=0.784) was not different, either. However, hemorrhagic infarction or parenchymal/subarachnoid hemorrhage on gradient-recalled echo magnetic resonance imaging occurred less frequently in the rosuvastatin group (6/137, 4.4%) than the placebo group (22/152, 14.5%, P=0.007). Among 314 patients with at least one dose of study medication, progression or clinical recurrence of stroke tended to occur less frequently in the rosuvastatin group (1/155, 0.6% vs. 7/159, 4.4%, P=0.067). Adverse events did not differ between groups. Conclusions The efficacy of rosuvastatin in reducing recurrence in acute stroke was inconclusive. However, statin use was safe and reduced hemorrhagic transformation.http://www.j-stroke.org/upload/pdf/jos-2015-01578.pdfstrokerosuvastatinstatindiffusion-weighted imaging |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ji Hoe Heo Dongbeom Song Hyo Suk Nam Eung Yeop Kim Young Dae Kim Kyung-Yul Lee Ki-Jeong Lee Joonsang Yoo Youn Nam Kim Byung Chul Lee Byung-Woo Yoon Jong S. Kim |
spellingShingle |
Ji Hoe Heo Dongbeom Song Hyo Suk Nam Eung Yeop Kim Young Dae Kim Kyung-Yul Lee Ki-Jeong Lee Joonsang Yoo Youn Nam Kim Byung Chul Lee Byung-Woo Yoon Jong S. Kim Effect and Safety of Rosuvastatin in Acute Ischemic Stroke Journal of Stroke stroke rosuvastatin statin diffusion-weighted imaging |
author_facet |
Ji Hoe Heo Dongbeom Song Hyo Suk Nam Eung Yeop Kim Young Dae Kim Kyung-Yul Lee Ki-Jeong Lee Joonsang Yoo Youn Nam Kim Byung Chul Lee Byung-Woo Yoon Jong S. Kim |
author_sort |
Ji Hoe Heo |
title |
Effect and Safety of Rosuvastatin in Acute Ischemic Stroke |
title_short |
Effect and Safety of Rosuvastatin in Acute Ischemic Stroke |
title_full |
Effect and Safety of Rosuvastatin in Acute Ischemic Stroke |
title_fullStr |
Effect and Safety of Rosuvastatin in Acute Ischemic Stroke |
title_full_unstemmed |
Effect and Safety of Rosuvastatin in Acute Ischemic Stroke |
title_sort |
effect and safety of rosuvastatin in acute ischemic stroke |
publisher |
Korean Stroke Society |
series |
Journal of Stroke |
issn |
2287-6391 2287-6405 |
publishDate |
2016-01-01 |
description |
Background and Purpose The benefit of statins in acute stroke remains uncertain. Statins may prevent stroke recurrence during the acute stage of stroke via pleiotropic effects. However, statins may increase the risk of intracerebral hemorrhage. We investigated the effect and safety of rosuvastatin in acute stroke patients. Methods This randomized, double-blind, multi-center trial compared rosuvastatin 20 mg and placebo in statin-naïve stroke patients who underwent diffusion-weighted imaging (DWI) within 48 hours after symptom onset. The primary outcome was occurrence of new ischemic lesions on DWI at 5 or 14 days. Results This trial was stopped early after randomization of 316 patients due to slow enrollment. Among 289 patients with at least one follow-up imaging, the frequency of new ischemic lesions on DWI was not different between groups (rosuvastatin: 27/137, 19.7% vs. placebo: 36/152, 23.6%) (relative risk 0.83, 95% confidence interval 0.53–1.30). Infarct volume growth at 5 days (log-transformed volume change, rosuvastatin: 0.2±1.0 mm3 vs. placebo: 0.3±1.3 mm3; P=0.784) was not different, either. However, hemorrhagic infarction or parenchymal/subarachnoid hemorrhage on gradient-recalled echo magnetic resonance imaging occurred less frequently in the rosuvastatin group (6/137, 4.4%) than the placebo group (22/152, 14.5%, P=0.007). Among 314 patients with at least one dose of study medication, progression or clinical recurrence of stroke tended to occur less frequently in the rosuvastatin group (1/155, 0.6% vs. 7/159, 4.4%, P=0.067). Adverse events did not differ between groups. Conclusions The efficacy of rosuvastatin in reducing recurrence in acute stroke was inconclusive. However, statin use was safe and reduced hemorrhagic transformation. |
topic |
stroke rosuvastatin statin diffusion-weighted imaging |
url |
http://www.j-stroke.org/upload/pdf/jos-2015-01578.pdf |
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