Statins Reduce Neurologic Injury in Asymptomatic Carotid Endarterectomy Patients
Statins Reduce Neurologic Injury in Asymptomatic Carotid Endarterectomy Patients
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DOI：
10.1161/strokeaha.111.000362
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发表时间：
2013-04-01
期刊：
影响因子：
8.3
通讯作者：
Connolly, E. Sander
中科院分区：
文献类型：
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作者：
Heyer, Eric J.;Mergeche, Joanna L.;Connolly, E. Sander
背景和目的——他汀类药物在多种脑损伤实验模型中具有神经保护作用。我们试图确定无症状颈动脉内膜切除术前服用他汀类药物的患者是否表现出较低的神经损伤发生率（临床卒中和认知功能障碍）。方法-共有 328 名计划进行择期颈动脉内膜切除术的无症状颈动脉狭窄患者同意参加这项围手术期神经损伤的观察性研究。结果-服用他汀类药物的患者临床卒中发生率较低（0.0% vs 3.1%；P=0.02）和认知功能障碍（11.0% vs 20.2%；P=0.03）。在多变量回归模型中，他汀类药物的使用与认知功能障碍的发生率降低显着相关（比值比，0.51 [95% CI，0.27-0.96]；P=0.04）。 结论：术前使用他汀类药物与无症状颈动脉内膜切除术后神经损伤的减少相关。这些观察结果表明，有可能进一步降低颈动脉内膜切除术的围手术期发病率。临床试验注册-URL：http://www.clinicaltrials.gov。唯一标识符：NCT00597883（中风。2013；44：1150-1152。）
Background and Purpose-Statins are neuroprotective in a variety of experimental models of cerebral injury. We sought to determine whether patients taking statins before asymptomatic carotid endarterectomy exhibit a lower incidence of neurological injury (clinical stroke and cognitive dysfunction).Methods-A total of 328 patients with asymptomatic carotid stenosis scheduled for elective carotid endarterectomy consented to participate in this observational study of perioperative neurological injury.Results-Patients taking statins had a lower incidence of clinical stroke (0.0% vs 3.1%; P=0.02) and cognitive dysfunction (11.0% vs 20.2%; P=0.03). In a multivariate regression model, statin use was significantly associated with decreased odds of cognitive dysfunction (odds ratio, 0.51 [95% CI, 0.27-0.96]; P=0.04).Conclusions-Preoperative statin use was associated with less neurological injury after asymptomatic carotid endarterectomy. These observations suggest that it may be possible to further reduce the perioperative morbidity of carotid endarterectomy.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00597883 (Stroke. 2013;44:1150-1152.)