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Effect and Safety of Rosuvastatin in Acute Ischemic Stroke

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Author(s)
Ji Hoe HeoDongbeom SongHyo Suk NamEung Yeop KimYoung Dae KimKyung-Yul LeeKi-Jeong LeeJoonsang YooYoun Nam KimByung Chul LeeByung-Woo YoonJong S. Kim
Keimyung Author(s)
Sohn, Sung Il
Department
Dept. of Neurology (신경과학)
Journal Title
Journal of Stroke
Issued Date
2016
Volume
18
Issue
1
Keyword
StrokeRosuvastatinStatinDiffusion-weighted imaging
Abstract
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.
Keimyung Author(s)(Kor)
손성일
Publisher
School of Medicine
Citation
Ji Hoe Heo et al. (2016). Effect and Safety of Rosuvastatin in Acute Ischemic Stroke. Journal of Stroke, 18(1), 87–95. doi: 10.5853/jos.2015.01578
Type
Article
ISSN
2287-6391
DOI
10.5853/jos.2015.01578
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33185
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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