Abdelrahman Hafez, Ahmed Abdelaziz, Ibrahim Kamal, Ahmed Farid Gadelmawla, Rehab Adel Diab, Shrouk Ramadan, Mohamed Hatem Ellabban, Ahmed Elaraby, Karim Atta, Mohamed Mahmoud Gomaa, Mohamed Abdelaziz, Ahmed O Sena, Ahmed Nasr, Mazen Hassanin, Omar Abdelgawwad, Ahmed Almahdy Mohamed, Ahmed Bahnasy, Emad Singer
{"title":"他汀类药物治疗对动脉瘤性蛛网膜下腔出血患者神经预后的影响：1464例患者的荟萃分析","authors":"Abdelrahman Hafez, Ahmed Abdelaziz, Ibrahim Kamal, Ahmed Farid Gadelmawla, Rehab Adel Diab, Shrouk Ramadan, Mohamed Hatem Ellabban, Ahmed Elaraby, Karim Atta, Mohamed Mahmoud Gomaa, Mohamed Abdelaziz, Ahmed O Sena, Ahmed Nasr, Mazen Hassanin, Omar Abdelgawwad, Ahmed Almahdy Mohamed, Ahmed Bahnasy, Emad Singer","doi":"10.1186/s12883-025-04286-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition complicated by cerebral vasospasm and deterioration of neurological functions. Statins have been proven to reduce the incidence of vasospasm and limit the neurological deterioration with controversial data. We aimed to give a comprehensive assessment of statins in patients with aSAH.</p><p><strong>Methods: </strong>We retrieved PubMed, Scopus, WOS, and the Cochrane library for RCTS assessing the efficacy of statins in patients with aSAH from inception to April 2024. Cerebral vasospasm and neurological deterioration were the primary efficacy outcomes of interest. Other secondary efficacy outcomes were delayed ischemic neurological deficits, and all-cause mortality. Safety outcomes were cerebral infarction, rhabdomyolysis, and elevated transaminase levels. STATA 18MP was used to analyze the data using a random-effect model.</p><p><strong>Results: </strong>A total of nine RCTs comprising 1464 patients, with a mean follow-up of 6 months were included in the final analysis. After 2 weeks of administration, statins were associated with a lower risk of cerebral vasospasm (OR: 0.74, 95% CI: 0.57 to 0.96, p = 0.03; I<sup>2</sup> = 0.00, p = 0.91), with no significant difference in the incidence of neurological deterioration (OR: 0.92, 95% CI: 0.75 to 1.14, p = 0.45; I<sup>2</sup> = 0.00, p = 0.84). There were no significant differences were observed in other reported outcomes.</p><p><strong>Conclusion: </strong>Statins were associated with reduced vasospasm with no notable improvement in neurological prognosis. However, the 2-week time window of statins is powered by small sample size, and further large-volume RCTs are warranted.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"349"},"PeriodicalIF":2.2000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376394/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of Statin Therapy on Neurological Outcomes in Aneurysmal Subarachnoid Hemorrhage: A Meta-Analysis of 1464 Patients.\",\"authors\":\"Abdelrahman Hafez, Ahmed Abdelaziz, Ibrahim Kamal, Ahmed Farid Gadelmawla, Rehab Adel Diab, Shrouk Ramadan, Mohamed Hatem Ellabban, Ahmed Elaraby, Karim Atta, Mohamed Mahmoud Gomaa, Mohamed Abdelaziz, Ahmed O Sena, Ahmed Nasr, Mazen Hassanin, Omar Abdelgawwad, Ahmed Almahdy Mohamed, Ahmed Bahnasy, Emad Singer\",\"doi\":\"10.1186/s12883-025-04286-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition complicated by cerebral vasospasm and deterioration of neurological functions. Statins have been proven to reduce the incidence of vasospasm and limit the neurological deterioration with controversial data. We aimed to give a comprehensive assessment of statins in patients with aSAH.</p><p><strong>Methods: </strong>We retrieved PubMed, Scopus, WOS, and the Cochrane library for RCTS assessing the efficacy of statins in patients with aSAH from inception to April 2024. Cerebral vasospasm and neurological deterioration were the primary efficacy outcomes of interest. Other secondary efficacy outcomes were delayed ischemic neurological deficits, and all-cause mortality. Safety outcomes were cerebral infarction, rhabdomyolysis, and elevated transaminase levels. STATA 18MP was used to analyze the data using a random-effect model.</p><p><strong>Results: </strong>A total of nine RCTs comprising 1464 patients, with a mean follow-up of 6 months were included in the final analysis. After 2 weeks of administration, statins were associated with a lower risk of cerebral vasospasm (OR: 0.74, 95% CI: 0.57 to 0.96, p = 0.03; I<sup>2</sup> = 0.00, p = 0.91), with no significant difference in the incidence of neurological deterioration (OR: 0.92, 95% CI: 0.75 to 1.14, p = 0.45; I<sup>2</sup> = 0.00, p = 0.84). There were no significant differences were observed in other reported outcomes.</p><p><strong>Conclusion: </strong>Statins were associated with reduced vasospasm with no notable improvement in neurological prognosis. However, the 2-week time window of statins is powered by small sample size, and further large-volume RCTs are warranted.</p>\",\"PeriodicalId\":9170,\"journal\":{\"name\":\"BMC Neurology\",\"volume\":\"25 1\",\"pages\":\"349\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376394/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12883-025-04286-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12883-025-04286-2","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
摘要
背景：动脉瘤性蛛网膜下腔出血（aSAH）是一种危及生命的疾病，并发脑血管痉挛和神经功能恶化。他汀类药物已被证明可以减少血管痉挛的发生率，并限制神经系统的恶化，但数据存在争议。我们的目的是对aSAH患者的他汀类药物进行全面评估。方法：检索PubMed、Scopus、WOS和Cochrane文库，对他汀类药物在aSAH患者中的疗效进行随机对照试验（RCTS）评估。脑血管痉挛和神经功能恶化是主要的疗效结局。其他次要疗效指标是迟发性缺血性神经功能缺损和全因死亡率。安全性结果为脑梗死、横纹肌溶解和转氨酶水平升高。采用STATA 18MP随机效应模型对数据进行分析。结果：共纳入9项rct，共1464例患者，平均随访6个月。给药2周后，他汀类药物与脑血管痉挛风险降低相关（OR: 0.74, 95% CI: 0.57 ~ 0.96, p = 0.03; I2 = 0.00, p = 0.91），神经功能恶化发生率无显著差异（OR: 0.92, 95% CI: 0.75 ~ 1.14, p = 0.45; I2 = 0.00, p = 0.84）。在其他报道的结果中没有观察到显著差异。结论：他汀类药物可减少血管痉挛，但对神经系统预后无显著改善。然而，他汀类药物的2周时间窗口是由小样本量驱动的，进一步的大容量随机对照试验是有必要的。
Effect of Statin Therapy on Neurological Outcomes in Aneurysmal Subarachnoid Hemorrhage: A Meta-Analysis of 1464 Patients.
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition complicated by cerebral vasospasm and deterioration of neurological functions. Statins have been proven to reduce the incidence of vasospasm and limit the neurological deterioration with controversial data. We aimed to give a comprehensive assessment of statins in patients with aSAH.
Methods: We retrieved PubMed, Scopus, WOS, and the Cochrane library for RCTS assessing the efficacy of statins in patients with aSAH from inception to April 2024. Cerebral vasospasm and neurological deterioration were the primary efficacy outcomes of interest. Other secondary efficacy outcomes were delayed ischemic neurological deficits, and all-cause mortality. Safety outcomes were cerebral infarction, rhabdomyolysis, and elevated transaminase levels. STATA 18MP was used to analyze the data using a random-effect model.
Results: A total of nine RCTs comprising 1464 patients, with a mean follow-up of 6 months were included in the final analysis. After 2 weeks of administration, statins were associated with a lower risk of cerebral vasospasm (OR: 0.74, 95% CI: 0.57 to 0.96, p = 0.03; I2 = 0.00, p = 0.91), with no significant difference in the incidence of neurological deterioration (OR: 0.92, 95% CI: 0.75 to 1.14, p = 0.45; I2 = 0.00, p = 0.84). There were no significant differences were observed in other reported outcomes.
Conclusion: Statins were associated with reduced vasospasm with no notable improvement in neurological prognosis. However, the 2-week time window of statins is powered by small sample size, and further large-volume RCTs are warranted.
期刊介绍：
BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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