Use of Statins for the Treatment of Spontaneous Intracerebral Hemorrhage: Results of a Pilot Study

Tapia-Pérez, Humberto; Sánchez-Aguilar, Martín; Torres-Corzo, Jaime Gerardo; Rodríguez-Leyva, Ildefonso; González-Aguirre, Daniel; Gordillo‐Moscoso, Antonio; Chalita-Williams, C

doi:10.1055/s-0028-1082064

Cited by 56 publications

(21 citation statements)

References 37 publications

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“…42,43 A pilot clinical study with rosuvastatin showed improved in-hospital mortality and National Institutes of Health stroke scale with further clinical trials planned. 44 Despite preclinical associations between statin use and mortality, and perihematomal edema, the Simvastatin for ICH Study, a phase 2, randomized, blinded, placebo-controlled, efficacy study evaluating treatment with 80 mg of simvastatin or placebo for 14 days on perihematomal edema was terminated because of poor recruitment. 45 Peroxisome proliferatoractivated receptor γ in microglia/macrophages has been found to promote hematoma absorption and protect other animal brain cells from ICH-induced damage.…”

Section: Pharmacological Manipulation Of Inflammation and Oxidative Smentioning

confidence: 99%

Hematology and Inflammatory Signaling of Intracerebral Hemorrhage

Ziai

2013

Stroke

129

120

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Section: Pharmacological Manipulation Of Inflammation and Oxidative Smentioning

confidence: 99%

Hematology and Inflammatory Signaling of Intracerebral Hemorrhage

Ziai

2013

Stroke

129

120

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“…The same patient population also demonstrated an association between statin use prior to ICH and decreased absolute and relative perihematomal edema at presentation [132]. There is a report of 1 small, prospective cohort of 18 patients treated with rosuvastatin compared to 57 historical controls [133]. The mortality rate during hospitalization was 5.6% in the statin group and 15.8% in the control group with an adjusted hazard ratio of 0.20 (95% CI 0.02-1.67), also suggesting that the use of statins during the acute phase of ICH may be associated with improved mortality.…”

Section: Anti-inflammatory Agents: Statinsmentioning

confidence: 87%

Treatment Targets in Intracerebral Hemorrhage

Sangha

Gonzales

2011

Neurotherapeutics

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Intracerebral hemorrhage (ICH) imparts a higher mortality and morbidity than ischemic stroke. The therapeutic interventions that are currently available focus mainly on supportive care and secondary prevention. There is a paucity of evidence to support any one acute intervention that improves functional outcome. This chapter highlights current treatment targets for ICH based on the pathophysiology of the disease.

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“…Fourth, our study cannot apply to clinical human trial yet. Although the benefits or advantages of statins have been studied in clinical trials with several groups [22], the studies with deferoxamine have been only accepted in the experimental laboratory-even though clinically used for some diseases such as thalassemia major and sickle cell anemia-due to its toxic side effect including ocular problems, auditory abnormalities, pancytopenia, pulmonary complications and bone abnormalities [23].…”

Section: Discussionmentioning

confidence: 99%

Effects of statin and deferoxamine administration on neurological outcomes in a rat model of intracerebral hemorrhage

Kim

et al. 2011

Neurol Sci

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Deferoxamine (DFX), a potent iron-chelating agent, reduces brain edema and neuronal cell injury that develop due to the hemolysis cascade. Statins have neuroprotective effects via anti-inflammatory action and increment of cerebral blood flow after intracerebral hemorrhage (ICH). The purpose of this study was to identify the effects of combined DFX and statins treatment in an experimental ICH rat model. The treatments were: intraperitoneal (i.p.) injection of DFX (group I), combined treatment of i.p. DFX and oral statins (group II), statins only (group III) and treatment with vehicle (group IV). Induction of ICH was performed with injection of bacterial collagenase type IV into the left striatum. After removal of the brain, hematoma volume, water content and brain atrophy were measured. Immunohistochemistry in the perihematomal region was performed for identification of microglial infiltration, astrocyte expression and apoptotic cell presence. Statistical analysis was performed using the non-parametric Kruskal-Wallis test and significance was evaluated when the p value was less than 0.05. According to behavioral tests, significant differences among treatment groups were noted 4 weeks after ICH induction (p < 0.05). However, there were no significant differences among treatment groups in hematoma volume, brain water content or brain atrophy. In the perihematomal area, the activated microglial cells were reduced in the combined treatment group. Among the four groups, a significant difference in immunohistochemical staining was identified (p < 0.05). These results suggest that combined treatment with DFX and statins improves neurologic outcomes after ICH through reduction of microglial infiltration, apoptosis, inflammation and brain edema.

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Use of Statins for the Treatment of Spontaneous Intracerebral Hemorrhage: Results of a Pilot Study

Abstract: The use of statins during the acute phase of ICH could be associated with a better outcome. Further clinical trials are necessary to confirm a possible therapeutic effect and evaluate the toxicity of statins.

Cited by 56 publications

References 37 publications

Hematology and Inflammatory Signaling of Intracerebral Hemorrhage

Hematology and Inflammatory Signaling of Intracerebral Hemorrhage

Treatment Targets in Intracerebral Hemorrhage

Effects of statin and deferoxamine administration on neurological outcomes in a rat model of intracerebral hemorrhage

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