Effects of acute pravastatin treatment on intensity of rescue therapy, length of inpatient stay, and 6-month outcome in patients after aneurysmal subarachnoid hemorrhage. Export

@article{citeulike:3475797, abstract = {BACKGROUND AND PURPOSE: We have previously demonstrated that acute pravastatin therapy after aneurysmal subarachnoid hemorrhage ameliorates vasospasm-related delayed ischemic deficits. This study assesses the effects of pravastatin on the frequency and intensity for rescue therapy, length of inpatient stay, and long-term outcome at 6 months. METHODS: Eighty aneurysmal subarachnoid hemorrhage patients (age 18 to 84 years, onset 1.8+/-1.3 days) were randomized to receive daily oral pravastatin (40 mg) or placebo for up to 14 days. Clinical events were recorded during the trial. Six-month outcome was assessed using the Short Form 36 and the modified Rankin Scale. RESULTS: Although no significant difference in the outcome at discharge was found between the trial groups, multivariate analysis showed pravastatin therapy reduced unfavorable outcome by 73\% (P=0.041). The benefit persisted at 6 months (P=0.063) and was notable in the physical (P<0.001) and psychosocial (P<0.001) aspects measured using Short Form 36. Furthermore, the acute pravastatin therapy reduced the requirement for triple-H therapy (hypertensive, hypervolemic, hemodilution; P=0.045) and mortality related to vasospasm (P=0.02) and sepsis (P=0.001); no significant difference was found in the length of inpatient stay between the trial groups. CONCLUSIONS: This trial demonstrates that acute statin treatment reduces traditional rescue therapy for vasospasm after aneurysmal subarachnoid hemorrhage. Improvement in early outcome has proved robust at 6 months, particularly in relation to physical and psychosocial (Short Form 36) outcome.}, author = {Tseng, M. Y. and Hutchinson, P. J. and Czosnyka, M. and Richards, H. and Pickard, J. D. and Kirkpatrick, P. J.}, citeulike-article-id = {3475797}, citeulike-linkout-0 = {http://dx.doi.org/10.1161/STROKEAHA.106.475905}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/17413047}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=17413047}, doi = {10.1161/STROKEAHA.106.475905}, issn = {1524-4628}, journal = {Stroke; a journal of cerebral circulation}, month = {May}, number = {5}, pages = {1545--1550}, posted-at = {2008-11-03 17:11:48}, priority = {2}, title = {Effects of acute pravastatin treatment on intensity of rescue therapy, length of inpatient stay, and 6-month outcome in patients after aneurysmal subarachnoid hemorrhage.}, url = {http://dx.doi.org/10.1161/STROKEAHA.106.475905}, volume = {38}, year = {2007} }

TY - JOUR ID - citeulike:3475797 L3 - citeulike-article-id:3475797 N2 - BACKGROUND AND PURPOSE: We have previously demonstrated that acute pravastatin therapy after aneurysmal subarachnoid hemorrhage ameliorates vasospasm-related delayed ischemic deficits. This study assesses the effects of pravastatin on the frequency and intensity for rescue therapy, length of inpatient stay, and long-term outcome at 6 months. METHODS: Eighty aneurysmal subarachnoid hemorrhage patients (age 18 to 84 years, onset 1.8+/-1.3 days) were randomized to receive daily oral pravastatin (40 mg) or placebo for up to 14 days. Clinical events were recorded during the trial. Six-month outcome was assessed using the Short Form 36 and the modified Rankin Scale. RESULTS: Although no significant difference in the outcome at discharge was found between the trial groups, multivariate analysis showed pravastatin therapy reduced unfavorable outcome by 73% (P=0.041). The benefit persisted at 6 months (P=0.063) and was notable in the physical (P<0.001) and psychosocial (P<0.001) aspects measured using Short Form 36. Furthermore, the acute pravastatin therapy reduced the requirement for triple-H therapy (hypertensive, hypervolemic, hemodilution; P=0.045) and mortality related to vasospasm (P=0.02) and sepsis (P=0.001); no significant difference was found in the length of inpatient stay between the trial groups. CONCLUSIONS: This trial demonstrates that acute statin treatment reduces traditional rescue therapy for vasospasm after aneurysmal subarachnoid hemorrhage. Improvement in early outcome has proved robust at 6 months, particularly in relation to physical and psychosocial (Short Form 36) outcome. IS - 5 JF - Stroke; a journal of cerebral circulation SN - 1524-4628 EP - 1550 TI - Effects of acute pravastatin treatment on intensity of rescue therapy, length of inpatient stay, and 6-month outcome in patients after aneurysmal subarachnoid hemorrhage. VL - 38 SP - 1545 AU - Tseng, MY AU - Hutchinson, PJ AU - Czosnyka, M AU - Richards, H AU - Pickard, JD AU - Kirkpatrick, PJ PY - 2007/05// UR - http://dx.doi.org/10.1161/STROKEAHA.106.475905 ER -