A randomized, double-blind, placebo-controlled pilot study of simvastatin in aneurysmal subarachnoid hemorrhage.

Abstract

BACKGROUND AND PURPOSE:

Studies suggest statins ameliorate aneurysmal subarachnoid hemorrhage (SAH)-induced cerebral vasospasm and ischemic complications. We tested safety and feasibility of simvastatin 80 mg/d for vasospasm prevention in SAH patients.

METHODS:

Thirty-nine statin-naïve Fisher grade 3 SAH subjects were double-blind randomized to receive simvastatin 80 mg/d (n=19) or placebo (n=20), stratified by Hunt and Hess grade. Primary end points were death and drug morbidity.

RESULTS:

Mortality was 3/20 in the placebo and 0/19 in the simvastatin group. Study drug was withdrawn in 1 subject in each treatment group for reversible liver enzyme or creatine phosphokinase elevation. Angiographically-confirmed vasospasm occurred in 8/20 placebo and 5/19 simvastatin-treated subjects. Vasospasm-related ischemic infarcts developed in 5/20 placebo and 2/19 simvastatin-treated subjects.

CONCLUSIONS:

Simvastatin for the prevention of delayed cerebral ischemia is safe and feasible after SAH. A larger study is needed to test its efficacy.

• Authors: Sherry H-Y Chou, Eric E Smith, Neeraj Badjatia, Raul G Nogueira, John R Sims 2nd, Christopher S Ogilvy, Guy A Rordorf, Cenk Ayata
• Journal: Stroke (Stroke) Vol. 39 Issue 10 Pg. 2891-3 (Oct 2008) ISSN: 1524-4628 [Electronic] United States
• PMID: 18658043 (Publication Type: Letter, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Simvastatin

Topics

• Double-Blind Method
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Male
• Middle Aged
• Pilot Projects
• Simvastatin (therapeutic use)
• Subarachnoid Hemorrhage (complications, drug therapy)
• Vasospasm, Intracranial (etiology, prevention & control)