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Effect and Safety of Rosuvastatin in Acute Ischemic Stroke

Authors
 Ji Hoe Heo  ;  Dongbeom Song  ;  Hyo Suk Nam  ;  Eung Yeop Kim  ;  Young Dae Kim  ;  Kyung-Yul Lee  ;  Ki-Jeong Lee  ;  Joonsang Yoo  ;  Youn Nam Kim  ;  Byung Chul Lee  ;  Byung-Woo Yoon  ;  Jong S. Kim 
Citation
 Journal of Stroke, Vol.18(1) : 87-95, 2016 
Journal Title
 Journal of Stroke 
ISSN
 2287-6391 
Issue Date
2016
Keywords
Diffusion-weighted imaging ; Rosuvastatin ; Statin ; Stroke
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 mm(3) vs. placebo: 0.3±1.3 mm(3); 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.
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DOI
10.5853/jos.2015.01578
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
김영대(Kim, Young Dae) ORCID logo https://orcid.org/0000-0001-5750-2616
김윤남(Kim, Youn Nam)
남효석(Nam, Hyo Suk) ORCID logo https://orcid.org/0000-0002-4415-3995
송동범(Song, Dong Beom)
유준상(Yoo, Joon Sang)
이경열(Lee, Kyung Yul) ORCID logo https://orcid.org/0000-0001-5585-7739
이기정(Lee, Ki Jeong)
허지회(Heo, Ji Hoe) ORCID logo https://orcid.org/0000-0001-9898-3321
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146369
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