Statins are associated with decreased mortality risk after status epilepticus
Statins are associated with decreased mortality risk after status epilepticus
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DOI：
10.1111/ene.12428
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发表时间：
2015-02-01
影响因子：
5.1
通讯作者：
Rossetti, A. O.
中科院分区：
文献类型：
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作者：
Sierra-Marcos, A.;Alvarez, V.;Rossetti, A. O.
背景和目的他汀类药物在动物模型中显示抗炎和抗癫痫的特性，并可能降低老年人癫痫的风险;然而，癫痫持续状态（SE）患者的结局可能的调节作用尚未被assessed.MethodsThis队列研究是基于一个前瞻性的注册表，包括2006年4月至2012年9月期间在我们中心治疗的所有连续成人事件SE。SE结果在出院时被分类为恢复基线“、新发残疾”和死亡“。潜在的预测因素，包括他汀类药物治疗入院的作用进行了评估，使用多项logistic回归model. ResultsAmong 427例患者确定，他汀类药物的信息可在413（97%）。平均年龄为60.9（17.8）岁; 201例（49%）为女性; 211例（51%）具有潜在致死性SE病因; 191例（46%）在昏迷中发生全身性惊厥或非惊厥性SE。76例（18%）受试者在入院前接受了他汀类药物（辛伐他汀、阿托伐他汀或普伐他汀）处方，大多数为老年人。208例（50.4%）患者恢复至基线水平，58例（14%）患者死亡。调整后建立的SE结果预测（年龄，病因，SE严重程度评分），他汀类药物与较低的死亡率显着相关（相对风险比0.38，P=0.046）。ConclusionThis研究表明，第一次暴露于他汀类药物前SE发作与其结果，涉及可能的抗癫痫作用。需要其他研究来证实这一有趣的发现。
Background and purposeStatins display anti-inflammatory and anti-epileptogenic properties in animal models, and may reduce the epilepsy risk in elderly humans; however, a possible modulating role on outcome in patients with status epilepticus (SE) has not been assessed.MethodsThis cohort study was based on a prospective registry including all consecutive adults with incident SE treated in our center between April 2006 and September 2012. SE outcome was categorized at hospital discharge into return to baseline', new disability' and mortality'. The role of potential predictors, including statins treatment on admission, was evaluated using a multinomial logistic regression model.ResultsAmongst 427 patients identified, information on statins was available in 413 (97%). Mean age was 60.9 (17.8) years; 201 (49%) were women; 211 (51%) had a potentially fatal SE etiology; and 191 (46%) experienced generalized-convulsive or non-convulsive SE in coma. Statins (simvastatin, atorvastatin or pravastatin) were prescribed prior to admission in 76 (18%) subjects, mostly elderly. Whilst 208 (50.4%) patients returned to baseline, 58 (14%) died. After adjustment for established SE outcome predictors (age, etiology, SE severity score), statins correlated significantly with lower mortality (relative risk ratio0.38, P=0.046).ConclusionThis study suggests for the first time that exposure to statins before an SE episode is related to its outcome, involving a possible anti-epileptogenic role. Other studies are needed to confirm this intriguing finding.