Early statin therapy in patients with acute intracerebral hemorrhage without prior statin use
Early statin therapy in patients with acute intracerebral hemorrhage without prior statin use
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DOI：
10.1111/ene.12649
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发表时间：
2015-05-01
影响因子：
5.1
通讯作者：
Li, Y. -H.
中科院分区：
文献类型：
--
作者：
Chen, P. -S.;Cheng, C. -L.;Li, Y. -H.
背景与目的
他汀类药物治疗对缺血性脑卒中的一级和二级预防有益，但其对脑出血（ICH）患者的影响尚不明确。本研究评估了早期他汀类药物治疗对急性脑出血患者的影响。
方法
对台湾全民健康保险研究数据库进行筛选，选取2008年1月至12月期间因新诊断的脑出血入院且既往未接受过他汀类药物治疗的患者。住院期间或出院后3个月内服用他汀类药物的患者为早期他汀组（n = 749）；未服用的患者为对照组（n = 7583）。研究终点为随访期间的脑出血复发和全因死亡率。
结果
对所有符合条件的患者进行随访，直至2010年12月31日。在随访期间，早期他汀组有69例（9.2%）患者，对照组有677例（8.9%）患者出现脑出血复发。Cox比例风险分析显示，早期使用他汀类药物不会增加脑出血复发的风险（调整后的风险比为1.044；95%置信区间为0.812 - 1.341）。在同一时期，早期他汀组有90例（12.0%）患者，对照组有1519例（20.0%）患者死亡。早期他汀组的全因死亡率（调整后的风险比为0.742；95%置信区间为0.598 - 0.919）低于对照组。匹配倾向评分分析结果与Cox比例风险分析结果一致。
结论
急性脑出血的早期他汀组患者脑出血复发风险并未升高，且在随访期间可能具有较低的全因死亡率。由此得出结论，他汀类药物治疗可能对脑出血患者有益。
Background and purposeStatin therapy is beneficial for primary and secondary prevention of ischaemic stroke, but its influence in patients with intracerebral hemorrhage (ICH) is unclear. An assessment was made of the effect of early statin therapy on patients with acute ICH.MethodsTaiwan's National Health Insurance Research Database was screened for patients without prior statin therapy admitted from January to December 2008 for newly diagnosed ICH. Patients taking statins during hospitalization or within 3months post-discharge were the early statin group (n=749); patients who were not were the control group (n=7583). The study end-points were recurrent ICH and all-cause mortality during follow-up.ResultsAll eligible patients were followed up until 31 December 2010. During the follow-up, 69 (9.2%) patients in the early statin group and 677 (8.9%) control group patients had recurrent ICH. Cox proportional hazards analyses showed that early statin use did not increase the risk of recurrent ICH (adjusted hazard ratio 1.044; 95% confidence interval 0.812-1.341). During the same period, 90 (12.0%) of the early statin group and 1519 (20.0%) control group patients died. All-cause mortality was lower in the early statin group (adjusted hazard ratio 0.742; 95% confidence interval 0.598-0.919) than in the control group. Matched propensity score analyses were consistent with findings in Cox proportional hazards analyses.ConclusionsEarly statin group patients with acute ICH did not have a higher recurrent risk of ICH and might have lower all-cause mortality during follow-up. It is concluded that statin therapy might be beneficial for patients with ICH.