{"title":"Effect of Statin Therapy following Endovascular Treatment of Intracranial Aneurysms: A Meta-Analysis.","authors":"Mingguo Li, Yuan Yao, Jian Liu, Yuanguang Pang, Qian Wu, Cong Liu","doi":"10.1159/000547504","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Endovascular treatment has become one of the standard therapies for intracranial aneurysms (IAs), yet the prognosis remains a persistent clinical challenge. This study aimed to systematically evaluate the efficacy and safety of adjuvant statin therapy following endovascular treatment (EVT) of IAs.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. Cohort studies comparing outcomes between patients with IAs who received statin therapy following EVT and those who did not were included. Efficacy outcomes included retreatment, recurrence, and complete occlusion, whereas safety outcomes included ischemic stroke, intracerebral hemorrhage (ICH), thrombosis, and all-cause mortality. A random-effects model was applied, and subgroup and sensitivity analyses were performed on the basis of treatment modality and adjustment for confounding factors.</p><p><strong>Results: </strong>Six retrospective studies comprising 3,692 patients were analyzed. Sensitivity analysis revealed that statin therapy significantly reduced the risk of retreatment (adjusted odds ratio [aOR] 0.35, 95% CI: 0.15-0.81) and recurrence (aOR 0.29, 95% CI: 0.12-0.65), whereas no significant difference was found in complete occlusion rates (aOR 0.94, 95% CI: 0.52-1.71). Although the unadjusted risk of ischemic stroke was greater in the statin group, this association was not significant after adjustment (aOR 1.04, 95% CI: 0.30-3.60). No significant differences were observed in other safety outcomes, including ICH, thrombosis, or all-cause mortality.</p><p><strong>Conclusion: </strong>Statins may help reduce the risk of recurrence and retreatment of IAs following EVT, suggesting their potential adjunctive role in the management of IAs and providing a rationale for conducting prospective investigations.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-12"},"PeriodicalIF":1.5000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cerebrovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000547504","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Endovascular treatment has become one of the standard therapies for intracranial aneurysms (IAs), yet the prognosis remains a persistent clinical challenge. This study aimed to systematically evaluate the efficacy and safety of adjuvant statin therapy following endovascular treatment (EVT) of IAs.
Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. Cohort studies comparing outcomes between patients with IAs who received statin therapy following EVT and those who did not were included. Efficacy outcomes included retreatment, recurrence, and complete occlusion, whereas safety outcomes included ischemic stroke, intracerebral hemorrhage (ICH), thrombosis, and all-cause mortality. A random-effects model was applied, and subgroup and sensitivity analyses were performed on the basis of treatment modality and adjustment for confounding factors.
Results: Six retrospective studies comprising 3,692 patients were analyzed. Sensitivity analysis revealed that statin therapy significantly reduced the risk of retreatment (adjusted odds ratio [aOR] 0.35, 95% CI: 0.15-0.81) and recurrence (aOR 0.29, 95% CI: 0.12-0.65), whereas no significant difference was found in complete occlusion rates (aOR 0.94, 95% CI: 0.52-1.71). Although the unadjusted risk of ischemic stroke was greater in the statin group, this association was not significant after adjustment (aOR 1.04, 95% CI: 0.30-3.60). No significant differences were observed in other safety outcomes, including ICH, thrombosis, or all-cause mortality.
Conclusion: Statins may help reduce the risk of recurrence and retreatment of IAs following EVT, suggesting their potential adjunctive role in the management of IAs and providing a rationale for conducting prospective investigations.
背景:血管内治疗已成为颅内动脉瘤(IAs)的标准治疗方法之一,但其预后仍是一个持续的临床挑战。本研究旨在系统评价IAs血管内治疗(EVT)后辅助他汀类药物治疗的有效性和安全性。方法:根据PRISMA指南进行系统评价和荟萃分析。队列研究比较了在EVT后接受他汀类药物治疗的IAs患者和未接受他汀类药物治疗的患者之间的结果。疗效指标包括再治疗、复发和完全闭塞,而安全性指标包括缺血性卒中、脑出血(ICH)、血栓形成和全因死亡率。采用随机效应模型,根据治疗方式和混杂因素调整进行亚组分析和敏感性分析。结果:6项回顾性研究包括3,692例患者。敏感性分析显示,他汀类药物治疗可显著降低再治疗风险(调整优势比[aOR] 0.35, 95% CI 0.15-0.81)和复发率(aOR 0.29, 95% CI 0.12-0.65),而完全闭塞率无显著差异(aOR 0.94, 95% CI 0.52-1.71)。尽管未经校正的缺血性卒中风险在他汀类药物组更高,但校正后这种关联并不显著(aOR 1.04, 95% CI 0.30-3.60)。其他安全性结果,包括脑出血、血栓形成或全因死亡率,没有观察到显著差异。结论:他汀类药物可能有助于降低EVT后IAs复发和再治疗的风险,表明其在IAs管理中的潜在辅助作用,并为开展前瞻性研究提供了依据。
期刊介绍:
A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.