Perihematoma cerebral blood flow is unaffected by statin use in acute intracerebral hemorrhage patients

Laura C. Gioia, Mahesh Kate, Rebecca Mccourt, Bronwen Gould, Shelagh B. Coutts, Dariush Dowlatshahi, Negar Asdaghi, Thomas Jeerakathil, Michael D. Hill, Andrew M. Demchuk, Brian Buck, Derek Emery, Ashfaq Shuaib, Kenneth Butcher

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Statin therapy has been associated with improved cerebral blood flow (CBF) and decreased perihematoma edema in animal models of intracerebral hemorrhage (ICH). We aimed to assess the relationship between statin use and cerebral hemodynamics in ICH patients. A post hoc analysis of 73 ICH patients enrolled in the Intracerebral Hemorrhage Acutely Decreasing Arterial Pressure Trial (ICH ADAPT). Patients presenting <24 hours from ICH onset were randomized to a systolic blood pressure target <150 or <180 mm Hg with computed tomography perfusion imaging 2 hours after randomization. Cerebral blood flow maps were calculated. Hematoma and edema volumes were measured planimetrically. Regression models were used to assess the relationship between statin use, perihematoma edema and cerebral hemodynamics. Fourteen patients (19%) were taking statins at the time of ICH. Statin-treated patients had similar median (IQR Q25 to 75) hematoma volumes (21.1 (9.5 to 38.3) mL versus 14.5 (5.6 to 27.7) mL, P=0.25), but larger median (IQR Q25 to 75) perihematoma edema volumes (2.9 (1.7 to 9.0) mL versus 2.2 (0.8 to 3.5) mL, P=0.02) compared with nontreated patients. Perihematoma and ipsilateral hemispheric CBF were similar in both groups. A multivariate linear regression model revealed that statin use and hematoma volumes were independent predictors of acute edema volumes. Statin use does not affect CBF in ICH patients. Statin use, along with hematoma volume, are independently associated with increased perihematoma edema volume.

Original languageEnglish (US)
Pages (from-to)1175-1180
Number of pages6
JournalJournal of Cerebral Blood Flow and Metabolism
Volume35
Issue number7
DOIs
StatePublished - Jul 1 2015
Externally publishedYes

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Cerebrovascular Circulation
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cerebral Hemorrhage
Edema
Hematoma
Linear Models
Hemodynamics
Blood Pressure
Perfusion Imaging
Brain Edema
Random Allocation
Arterial Pressure
Animal Models
Tomography

Keywords

  • intracerebral hemorrhage
  • perfusion imaging
  • perihematoma edema
  • statins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Neurology

Cite this

Gioia, L. C., Kate, M., Mccourt, R., Gould, B., Coutts, S. B., Dowlatshahi, D., ... Butcher, K. (2015). Perihematoma cerebral blood flow is unaffected by statin use in acute intracerebral hemorrhage patients. Journal of Cerebral Blood Flow and Metabolism, 35(7), 1175-1180. https://doi.org/10.1038/jcbfm.2015.36

Perihematoma cerebral blood flow is unaffected by statin use in acute intracerebral hemorrhage patients. / Gioia, Laura C.; Kate, Mahesh; Mccourt, Rebecca; Gould, Bronwen; Coutts, Shelagh B.; Dowlatshahi, Dariush; Asdaghi, Negar; Jeerakathil, Thomas; Hill, Michael D.; Demchuk, Andrew M.; Buck, Brian; Emery, Derek; Shuaib, Ashfaq; Butcher, Kenneth.

In: Journal of Cerebral Blood Flow and Metabolism, Vol. 35, No. 7, 01.07.2015, p. 1175-1180.

Research output: Contribution to journalArticle

Gioia, LC, Kate, M, Mccourt, R, Gould, B, Coutts, SB, Dowlatshahi, D, Asdaghi, N, Jeerakathil, T, Hill, MD, Demchuk, AM, Buck, B, Emery, D, Shuaib, A & Butcher, K 2015, 'Perihematoma cerebral blood flow is unaffected by statin use in acute intracerebral hemorrhage patients', Journal of Cerebral Blood Flow and Metabolism, vol. 35, no. 7, pp. 1175-1180. https://doi.org/10.1038/jcbfm.2015.36
Gioia, Laura C. ; Kate, Mahesh ; Mccourt, Rebecca ; Gould, Bronwen ; Coutts, Shelagh B. ; Dowlatshahi, Dariush ; Asdaghi, Negar ; Jeerakathil, Thomas ; Hill, Michael D. ; Demchuk, Andrew M. ; Buck, Brian ; Emery, Derek ; Shuaib, Ashfaq ; Butcher, Kenneth. / Perihematoma cerebral blood flow is unaffected by statin use in acute intracerebral hemorrhage patients. In: Journal of Cerebral Blood Flow and Metabolism. 2015 ; Vol. 35, No. 7. pp. 1175-1180.
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abstract = "Statin therapy has been associated with improved cerebral blood flow (CBF) and decreased perihematoma edema in animal models of intracerebral hemorrhage (ICH). We aimed to assess the relationship between statin use and cerebral hemodynamics in ICH patients. A post hoc analysis of 73 ICH patients enrolled in the Intracerebral Hemorrhage Acutely Decreasing Arterial Pressure Trial (ICH ADAPT). Patients presenting <24 hours from ICH onset were randomized to a systolic blood pressure target <150 or <180 mm Hg with computed tomography perfusion imaging 2 hours after randomization. Cerebral blood flow maps were calculated. Hematoma and edema volumes were measured planimetrically. Regression models were used to assess the relationship between statin use, perihematoma edema and cerebral hemodynamics. Fourteen patients (19{\%}) were taking statins at the time of ICH. Statin-treated patients had similar median (IQR Q25 to 75) hematoma volumes (21.1 (9.5 to 38.3) mL versus 14.5 (5.6 to 27.7) mL, P=0.25), but larger median (IQR Q25 to 75) perihematoma edema volumes (2.9 (1.7 to 9.0) mL versus 2.2 (0.8 to 3.5) mL, P=0.02) compared with nontreated patients. Perihematoma and ipsilateral hemispheric CBF were similar in both groups. A multivariate linear regression model revealed that statin use and hematoma volumes were independent predictors of acute edema volumes. Statin use does not affect CBF in ICH patients. Statin use, along with hematoma volume, are independently associated with increased perihematoma edema volume.",
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