Original Article

The Effect of Intensive Statin Therapy on Symptomatic Intracranial Arterial Stenosis

Abstract

Background: The aim of this study was to observe the effect of intensive statin therapy on symptomatic intracranial arterial stenosis.

Methods: overall, 120 patients with symptomatic intracranial arterial stenosis were admitted to the Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China from January 2010 to May 2013. They were randomly divided into three groups and were given different doses of atorvastatin orally for 1 year or more, and followed up for 12 months. The three groups were assessed for clinical end-point event rates and changes in cerebral blood flow value before and after treatment to assess the effectiveness of intensive statin therapy.

Results: The incidence rates of end-point cerebrovascular events in the low-dose group (10 mg/d), the general-dose group (20 mg/d) and the intensive treatment group (40 mg/d) were 26.3%, 13.5% and 5.4% respectively during the 12-month follow-up after treatment. There was a significant difference between the low dose group and the intensive treatment group (P<0.05). The relative cerebral blood flow and relative cerebral blood volume of the three groups were significantly higher than those before treatment (P<0.05), and the relative time to peak for the intensive treatment group was shorter than that before treatment (P<0.001).

Conclusion: Atorvastatin at 40 mg/d has a significant advantage compared with atorvastatin at 20 mg/d and 10 mg/d in reducing cerebrovascular events and improving cerebral blood flow. 

  

  Keywords: Statin, Enhanced lipid-lowering, Intracranial atherosclerotic stenosis, CT perfusion imaging

 

Gorelick PB, Wong KS, Bae HJ, Pandey DK (2008). Large artery intracranial occlusive disease: A large worldwide burden but a relatively neglected frontier. Stroke, 39: 2396–2399.

Ní Chróinín D, Asplund K, Åsberg S et al (2013). Statin therapy and outcome after ischemic stroke: Systematic review and meta-analysis of observational studies and randomized trials. Stroke, 44: 448–456.

Aboa-Eboulé C, Binquet C, Jacquin A, Hervieu M, Bonithon-Kopp C, Durier J, Giroud M, Béjot Y (2012). Effect of pre-vious statin therapy on severity and out-come in ischemic stroke patients: a popu-lation-based study. J Neurol, 260(1):30-7.

Liebeskind DS, Cotsonis GA, Saver JL et al (2011). Collaterals dramatically alter stroke risk in intracranial atherosclerosis. Ann Neurol, 69: 963–974.

Lau AYL, Wong EHC, Wong A, Mok VCT, Leung TW, Wong KSL (2012). Signifi-cance of good collateral compensation in symptomatic intracranial atherosclerosis. Cerebrovasc Dis, 33: 517–524.

Amarenco P, Bogousslavsky J, Callahan A 3rd et al (2006). High-dose atorvastatin af-ter stroke or transient ischemic attack. N Engl J Med, 355: 549–559.

Nissen SE, Nicholls SJ, Sipahi I, et al (2006). Effect of Very High-Intensity Statin Therapy on Regression of Coronary Atherosclerosis: the ASTEROID trial. J Am Med Assoc, 295: 1556-65.

Nabavi DG, Cenic A, Henderson S, Gelb AW, Lee TY (2001). Perfusion mapping using computed tomography allows accu-rate prediction of cerebral infarction in experimental brain ischemia. Stroke, 32: 175–183.

van Seeters T, Biessels GJ, Kappelle LJ et al (2016). Dutch acute stroke study (DUST) investigators: CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circula-tion stroke. Neuroradiology, 58:327-337.

Castilla Guerra L, del Carmen Fernández Moreno M, López Chozas JM, Jiménez Hernández MD (2008). Statins in stroke prevention: What an internist should know. Eur J Intern Med, 19: 8–14.

Manocha D, Bansal N, Gumaste P, Brang-man S (2013). Safety profile of high-dose statin therapy in geriatric patients with stroke. South Med J, 106: 658–664.

Files
IssueVol 47 No 2 (2018) QRcode
SectionOriginal Article(s)
Keywords
Statin Enhanced lipid-lowering Intracranial atherosclerotic stenosis CT perfusion imaging

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
ZHOU P, CAO Z, WANG P, LIU G, YAO X, WANG P, LI G, ZHANG G, GAO P. The Effect of Intensive Statin Therapy on Symptomatic Intracranial Arterial Stenosis. Iran J Public Health. 2018;47(2):231-236.