Combining statins with tissue plasminogen activator treatment after experimental and human stroke: a safety study on hemorrhagic transformation.

Abstract

AIMS:

Statins may afford neuroprotection against ischemic injury, but it remains controversial whether combined treatment with tissue plasminogen activator (tPA) after stroke increases the risk of hemorrhagic transformation (HT), the major tPA-related complication. We evaluated the safety of combining statin with tPA administration during the acute phase of both experimental and human stroke.

METHODS:

The occurrence and severity of HT, infarct volume, and neurological outcome were evaluated in spontaneous hypertensive rats (SHR) subjected to embolic middle cerebral arterial occlusion (MCAO), which received vehicle or simvastatin (20 mg/kg), 15 min after ischemia and tPA (9 mg/kg) 3 h after ischemia. Additionally, HT rate was evaluated in stroke patients who were treated with tPA (0.9 mg/kg) within 3 h after symptom onset, considering whether or not were under statins treatment when the stroke occurred.

RESULTS:

In the experimental study, no differences in HT rates and severity were found between treatment groups, neither regarding mortality, neurological deficit, infarct volume, or metalloproteinases (MMPs) brain content. In the clinical study, HT rates and hemorrhage type were similar in stroke patients who were or not under statins treatment.

CONCLUSION:

This study consistently confirms that the use of statins does not increase HT rates and severity when is combined with tPA administration.

• Authors: Mireia Campos, Lidia García-Bonilla, Mar Hernández-Guillamon, Verónica Barceló, Anna Morancho, Manolo Quintana, Marta Rubiera, Anna Rosell, Joan Montaner
• Journal: CNS neuroscience & therapeutics (CNS Neurosci Ther) Vol. 19 Issue 11 Pg. 863-70 (Nov 2013) ISSN: 1755-5949 [Electronic] England
• PMID: 24118905 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 John Wiley & Sons Ltd.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Tissue Plasminogen Activator

Topics

• Aged
• Aged, 80 and over
• Animals
• Cerebral Hemorrhage (chemically induced, pathology)
• Cohort Studies
• Drug Therapy, Combination
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, adverse effects)
• Male
• Middle Aged
• Pilot Projects
• Prospective Studies
• Random Allocation
• Rats
• Rats, Inbred SHR
• Stroke (drug therapy, pathology)
• Tissue Plasminogen Activator (administration & dosage, adverse effects)