Association between statin use and intracerebral hemorrhage: a systematic review and meta-analysis
Article first published online: 7 OCT 2013
© 2013 West China Hospital, Sichuan University European Journal of Neurology © 2013 EFNS
European Journal of Neurology
Volume 21, Issue 2, pages 192–198, February 2014
How to Cite
Lei, C., Wu, B., Liu, M. and Chen, Y. (2014), Association between statin use and intracerebral hemorrhage: a systematic review and meta-analysis. European Journal of Neurology, 21: 192–198. doi: 10.1111/ene.12273
- Issue published online: 13 JAN 2014
- Article first published online: 7 OCT 2013
- Manuscript Accepted: 26 AUG 2013
- Manuscript Received: 7 JUL 2013
- Foundation of the Ministry of Education of China. Grant Number: 20110181110026
- Department of Science and Technology of Sichuan Province. Grant Number: 2012FZ0006
- functional outcome;
- intracerebral hemorrhage;
Background and purpose
Accumulating evidence suggests that statins exert neuroprotective effects, but whether their use affects the outcomes of intracerebral hemorrhage (ICH) remains controversial. Therefore, we performed a systematic review and meta-analysis to investigate whether statin use before spontaneous ICH affects unfavorable functional outcome or mortality.
We searched the Cochrane Library, MEDLINE, EMBASE and China National Knowledge Infrastructure databases for studies examining the effects of pre-ICH statin use on unfavorable functional outcome, mortality or neuroimaging outcomes in consecutively recruited patients with spontaneous ICH, regardless of the duration or dose of statin treatment.
A total of 12 studies were included that examined the effects of pre-ICH statin use on post-ICH outcomes in 1652 subjects in the favors pre-statin group and 5309 in the favors no pre-ICH statin group. Meta-analysis of 11 studies suggested that pre-ICH statin use did not significantly affect mortality across all three time points tested [in-hospital, 30 days, 90 days; odds ratio (OR) 0.85, 95% confidence interval (CI) 0.70–1.03]. However, meta-analysis of seven studies showed that pre-ICH statin use did significantly decrease 90-day mortality (OR 0.72, 95% CI 0.59–0.88). Meta-analysis of six studies showed that pre-ICH statin use was not associated with significant changes in unfavorable functional outcome. Moreover, pre-ICH statin use did not significantly affect admission hematoma volume (standardized mean difference 7.75, 95% CI −5.59 to 21.09).
Available evidence suggests that statin use before spontaneous ICH does not increase short-term mortality, unfavorable functional outcome or post-ICH hematoma volume at admission.