11年抄读.ppt

Statin use and outcome after intracerebral hemorrhageCase-control study and meta-analysis Neurology 2011;76:1581–1588 ABSTRACT Objectives: Accumulating data suggests that statins have neuroprotective effects. We erformed a meta-analysis of all available evidence, including unpublished data from our own institution, to determine whether statin exposure is protective for patients who develop ICH. ABSTRACT Methods: In our prospectively cohort, we compared 90-day functional outcome in 238 pre-ICH statin cases and 461 statin-free ICH cases. We then meta-analyzed results from our cohort along with previously published studies using a random effects model, for a total of 698 ICH statin cases and 1,823 non–statin-exposed subjects. ABSTRACT Results: Data from our center demonstrated an association between statin use before ICH and increased probability of favorable outcome and reduced mortality at 90 days. No compound-specific statin effect was identified. Meta-analysis of all published evidence confirmed the effect of statin use on good outcome and mortality after ICH. ABSTRACT Conclusion: Antecedent use of statins prior to ICH is associated with favorable outcome and reduced mortality after ICH. This phenomenon appears to be a class effect of statins. Several studies investigating animal models of ICH suggest that statins exert a beneficial effect on functional recovery. These findings could be explained by the effect of statins on lipid metabolism, or by other effects including neuroprotection and stimulation of neurogenesis and synaptogenesis. Evidence from observational studies in patients, however, is conflicting, with some groups reporting reduced mortality or improved outcome after ICH in individuals using statins before the event, and others failing to replicate this association. We performed a meta-analysis of all available evidence to clarify whether pre-ICH statin use influences functional outcome and mortality. In order to increase our statistical power, we