High-Dose Simvastatin Is Effective in Preventing Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage : A Prospective Cohort Study in Korean Patients

Woo, Sung Woong; Kim, Jae Hoon; Kang, Hee In; Kim, Deok Ryeong; Moon, Byung Gwan; Kim, Joo Seung

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자료유형: 학술저널

저자정보: Woo, Sung Woong (Department of Neurosurgery, Eulji University School of Medicine) Kim, Jae Hoon (Department of Neurosurgery, Eulji University School of Medicine) Kang, Hee In (Department of Neurosurgery, Eulji University School of Medicine) Kim, Deok Ryeong (Department of Neurosurgery, Eulji University School of Medicine) Moon, Byung Gwan (Department of Neurosurgery, Eulji University School of Medicine) Kim, Joo Seung (Department of Neurosurgery, Eulji University School of Medicine)

저널정보: 대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제58권 제4호

발행연도: 2015.1

수록면: 328 - 333 (6page)

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Objective : The goal of this study was to assess the effect of high-dose simvastatin on cerebral vasospasm and its clinical outcome after aneurysmal subarachnoid hemorrhage (SAH) in Korean patients. Methods : This study was designed as a prospective observational cohort study. Its subjects were aneurysmal SAH patients who had undergone aneurysm clipping or coiling. They were assigned to 1 of 3 groups : the 20 mg, 40 mg, and 80 mg simvastatin groups. The primary end-point was the occurrence of symptomatic vasospasm. The clinical outcome was assessed with the modified Rankin Scale (mRS) score after 1 month and 3 months. The risk factors of the development of vasospasm were assessed by logistic regression analysis. Results : Ninety nine patients with aneurysmal SAH were treated and screened. They were sequentially assigned to the 20 mg (n=22), 40 mg (n=34), and 80 mg (n=31) simvastatin groups. Symptomatic vasospasm occurred in 36.4% of the 20 mg group, 8.8% of the 40 mg group, and 3.2% of the 80 mg group (p=0.003). The multiple logistic regression analysis showed that poor Hunt-Hess grades (OR=5.4 and 95% CI=1.09-26.62) and high-dose (80 mg) simvastatin (OR=0.09 and 95% CI=0.1-0.85) were independent factors of symptomatic vasospasm. The clinical outcomes did not show a significant difference among the three groups. Conclusion : This study demonstrated that 80 mg simvastatin treatment was effective in preventing cerebral vasospasm after aneurysmal SAH, but did not improve the clinical outcome in Korean patients.

#Outcome #Statin #Subarachnoid hemorrhage #Vasospasm

참고문헌 (17)

참고문헌 신청

Chou SH. / 2008 / A randomized, double-blind, placebo-controlled pilot study of simvastatin in aneurysmal subarachnoid hemorrhage / Stroke 39:2891~2893

Endres M. / 1998 / Stroke protection by 3-hydroxy-3-methylglutaryl(HMG)-CoA reductase inhibitors mediated by endothelial nitric oxide synthase / Proc Natl Acad Sci U S A 95:8880~8885

좌철수 / 2011 / Prior Use of 3-Hydroxy-3-Methyl-Glutaryl-Coenzyme A Reductase Inhibitor, Simvastatin Fails to Improve Outcome after Experimental Intracerebral Hemorrhage / 대한신경외과학회지 50(5):403~408

Karki K. / 2009 / Simvastatin and atorvastatin improve neurological outcome after experimental intracerebral hemorrhage / Stroke 40:3384~3389

Kassell NF. / 1990 / The International cooperative study on the timing of aneurysm surgery. Part 1, overall management results / J Neurosurg 73:18~36

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이 논문의 저자 정보

Woo, Sung Woong

소속기관 Department of Neurosurgery, Eulji University School of Medicine

주요연구분야 의약학 > 임상의학 > 신경외과학

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Kim, Jae Hoon