Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：CNS NEUROSCIENCE & THERAPEUTICS

Publication type: Original Contributions

IF(IF): 5.243

PMID: 2014; 20:548–555. Link To Pubmed Full text Download

Spontaneous intracerebral hemorrhage (ICH) causes about 15% of all strokes in Western populations but 20–30% of strokes in Chinese population [1–4]. Patients with ICH generally have a poorer prognosis and higher case fatality rate compared with those with ischemic strokes [1,5]. Statins are 3-hydroxy- 3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors. Even though they are primarily used as cholesterol lowering agents, they also possess potential neuronal protective effects in ICH. Such benefit has been reported in several animal studies [6–8]. However, this benefit is inconclusive in human [9–18]. Several studies suggested that prior [9,11,12,14] or continued [16,17] statin use by ICH patients has improved their func- tional outcome, but others reported no significant change [10,13,15,18]. Some even suggested that there is an indepen- dent association of statin to higher risks of developing ICH [19]. Therefore, the use of statin therapy after ICH remains controversial [20–23]. Using the data from the China National Stroke Registry (CNSR) [4], we examined the relationship between statin treatment in ICH patients during their hospitalization and outcomes.

Study Design and Population Data were collected from CNSR [4,5], a nationwide prospective registry of 21,902 consecutive patients with a diagnosis of ischemic stroke, ICH or transient ischemic attack from 132 hos- pitals in China between September 2007 and August 2008. Data on demographics, vascular risk factors, clinical characteris- tics, medical therapies and outcomes at the 3-, 6-, 12-month follow-up visits were collected. The collection of data for the CNSR study was approved by ethics committees at all partici- pating hospitals. All patients or his/her legal representatives gave written informed consent before being entered into the registry. ICH was diagnosed according to the World Health Organization criteria [24] and confirmed by brain computerized tomography (CT). ICH patients older than 18 and presented to hospital within 14 days after the onset of symptoms were eligible for this study. Patients were excluded if they had any one of these conditions: ICH caused by brain tumor, data on ICH hematoma volume were unavailable, primary intraventricular hemorrhage, their prestroke modified Rankin Scale (mRS) was >2, and those did not give con- sents or lost to follow-up. We also excluded patients with history of prestroke use of lipid lowering agents to avoid its impact on the outcome for the current analysis [9,11,12]. Details on the design, rationale and methodology of CNSR have been published previously [4,5].