Statin treatment for cerebral small vessel disease: A systematic review and meta-analysis of randomized controlled trials

IF 2.8 Q3 CLINICAL NEUROLOGY

Cerebral circulation - cognition and behavior Pub Date : 2025-01-01 DOI:10.1016/j.cccb.2025.100389

David Fresnais , Brynjar Fure

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Abstract

Background

Cerebral small vessel disease (CSVD) is a chronic, progressive disorder that affects small blood vessels in the brain's white matter. This white matter damage appears on brain imaging as white matter hyperintensities (WMH). Although CSVD is often asymptomatic, it causes one fifth of strokes and nearly half of all vascular dementia cases, highlighting its clinical importance. Statins, widely used to lower lipid levels, are effective for reducing cardiovascular mortality in high-risk groups and are recommended for patients with myocardial infarction and ischemic stroke.

Aim

This systematic review and meta-analysis of randomized controlled trials aimed to evaluate the impact of statin therapy on CSVD.

Method

A literature search was performed in PubMed, Embase, the Cochrane Library and Epistemonikos resulting in the full-text review of 86 articles, of which two were used for the meta-analysis.

Results

A non-significant trend towards lower WMH volume in milliliters was observed in the statin group compared to controls, mean difference (MD) = -4.44 (95 % CI -10.19–1.31).

Conclusion

There is limited evidence available for the use of stain-treatment for CSVD, and further research is needed as well as studies on the clinical and person-centered benefits of statins on cognition and functional level in persons with CSVD.

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他汀类药物治疗脑血管疾病：随机对照试验的系统回顾和荟萃分析

背景：脑小血管疾病（CSVD）是一种慢性进行性疾病，影响脑白质中的小血管。这种白质损伤在脑成像上表现为白质高信号（WMH）。虽然CSVD通常无症状，但它导致了五分之一的中风和近一半的血管性痴呆病例，突出了其临床重要性。他汀类药物广泛用于降低血脂水平，可有效降低高危人群的心血管死亡率，推荐用于心肌梗死和缺血性卒中患者。目的本研究对随机对照试验进行系统回顾和荟萃分析，旨在评价他汀类药物治疗对心血管疾病的影响。方法在PubMed、Embase、Cochrane Library和Epistemonikos中进行文献检索，共收录86篇文章全文，其中2篇用于meta分析。结果与对照组相比，他汀类药物组患者WMH（毫升）体积下降趋势不显著，平均差异(MD) = -4.44 （95% CI -10.19-1.31）。结论使用染色治疗CSVD的证据有限，需要进一步的研究，以及他汀类药物对CSVD患者认知和功能水平的临床和以人为中心的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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