The Effect of Simvastatin on Acute Phase Functional Outcome of Ischemic Stroke
Downloads
Introduction: Stroke is one of the leading causes of death and disability worldwide, and especially in Indonesia. Several studies showed the pleiotropic and neuroprotective effect of simvastatin in addition to lowering blood cholesterol levels. Objective: This trial was conducted to investigate if the administration of simvastatin in acute ischemic stroke management can improve functional outcomes. Methods: This randomized, double-blind, placebo-controlled trial of simvastatin was conducted in patients with acute ischemic stroke with an NIHSS score of 4-14. Participants were randomly assigned to receive 40 mg of simvastatin or placebo for seven days. The NIHSS scale was compared on admission day, 4th and 8th day after administration of simvastatin between the two groups. Results: 52 individuals were randomized: 28 to simvastatin and 24 to placebo. There was no significant improvement of functional outcome between the two groups (p > 0.05). Conclusion: Administration of simvastatin had no significant effect on outcome (measured by NIHSS) in patients with acute ischemic stroke.
Krishnamurthi RV, Ikeda T, Feigin VL. Global, regional and country-specific burden of ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage: A systematic analysis of the global burden of disease study 2017. Neuroepidemiology. 2020;54(2):171–9.
Katan M, Luft A. Global burden of stroke. Semin Neurol. 2018;38(2):208–11.
Yudiarto F, Machfoed MH, Amir D, Ong A, Kurniawan M, Siswanto, et al. Hypertension is the most risk factor stroke in Indonesia Stroke Registry. Neurology. 2017;88 (16 Sup:P3.263.
Yudiarto F, Machfoed M, Darwin A, Ong A, Karyana M, Siswanto. Indonesia stroke registry. Neurology. 2014;82 (10 Sup:S12.003.
Chroinin DN, Callaly EL, Duggan J, Merwick A, Hannon N, Sheehan O, et al. Association between acute statin therapy, survival, and improved functional outcome after ischemic stroke. Stroke. 2011;42(4):1021–9.
Sett AK, Robinson TG, Mistri AK. Current status of statin therapy for stroke prevention. Expert Rev Cardiovasc Ther. 2011;9(10):1305–14.
Sakurai K, Isahaya K, Takaishi S, Kato B, Shimizu K, Shimomura K, et al. Effects of early statin treatment on inflammatory biomarkers and clinical deterioration in patients with acute ischemic stroke. Clinial Neurol. 2011;51:6–13.
Scheneider MP, Schmidt BM, John S, Schmieder RE. Effects of statin treatment on endothelial function, oxidative stress and inflammation in patients with arterial hypertension and normal cholesterol levels. J Hypertens. 2011;29(9):1757–64.
Garcia-Bonilla L, Campos M, Giralt D, Salat D, Chacon P, Hernandez-Guillamon M, et al. Evidence for the efficacy of statins in animal stroke models: A meta-analysis. J Neurochem. 2012;122(2):233–43.
Fisher M, Moonis M. Neuroprotective effects of statins: Evidence from preclinical and clinical studies. Curr Treat Options Cardiovasc Med. 2012;14(3):252–9.
Wang Q, Yan J, Chen X, Li J, Yang Y, Weng JP, et al. Statins: Multiple neuroprotective mechanisms in neurodegenerative diseases. Exp Neurol. 2011;230(1):27–34.
Szczepanska-Szerej A, Kurzepa J, Wojczal J, Stelmasiak Z. Simvastatin displays an antioxidative effect by inhibiting an increase in the serum 8-isoprostane level in patients with acute ischemic stroke: Brief report. Clin Neuropharmacol. 2011;34(5):191–4.
Prinz V, Endres M. Statins and stroke: Prevention and beyond. Curr Opin Neurol. 2011;24(1):75–80.
McFarland AJ, Anoopkumar-Dukie S, Arora DS, Grant GD, McDermott CM, Perkins A V., et al. Molecular mechanisms underlying the effects of statins in the central nervous system. Int J Mol Sci. 2014;15(11):20607–37.
Giannopoulos S, Katsanos AH, Tsivgoulis G, Marshall RS. Statins and cerebral hemodynamics. J Cereb Blood Flow Metab. 2012;32(11):1973–6.
Hong KS, Lee JS. Statins in acute ischemic stroke: A systematic review. J Stroke. 2015;17(3):282–301.
Chroinin DN, Callaly EL, Duggan J, Merwick Á, Hannon N, Sheehan Q, et al. Association between acute statin therapy, survival, and improved functional outcome after ischemic stroke: The North Dublin population stroke study. Stroke. 2011;42(4):1021–9.
Zhao J, Zhang X, Dong L, Wen Y, Cui L. The Many Roles of Statins in Ischemic Stroke. Curr Neuropharmacol. 2014;12(6):564–74.
Bu DX, Griffin G, Lichtman AH. Mechanisms for the anti-inflammatory effects of statins. Curr Opin Lipidol. 2011;22(3):165–70.
Carloni S, Balduini W. Simvastatin preconditioning confers neuroprotection against hypoxia-ischemia induced brain damage in neonatal rats via autophagy and silent information regulator 1 (SIRT1) activation. Exp Neurol. 2020;324:113117
Copyright (c) 2022 Fidiana Fidiana, Paulus Sugianto
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.