Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age
Abstract Background Statins have been recommended by several guidelines as the primary prevention medication for cardiovascular diseases. However, the benefits of statin therapy for cerebral small vessel disease (CSVD), particularly in adults ≥75 years of age, have not been fully evaluated. Methods...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | BMC Geriatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12877-020-01682-w |
| _version_ | 1818244026011222016 |
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| author | Yuqi Guo Yunpeng Li Xukui Liu Yi Cui Yingxin Zhao Shangwen Sun Qing Jia Qiang Chai Gary Gong Hua Zhang Zhendong Liu |
| author_facet | Yuqi Guo Yunpeng Li Xukui Liu Yi Cui Yingxin Zhao Shangwen Sun Qing Jia Qiang Chai Gary Gong Hua Zhang Zhendong Liu |
| author_sort | Yuqi Guo |
| collection | DOAJ |
| description | Abstract Background Statins have been recommended by several guidelines as the primary prevention medication for cardiovascular diseases. However, the benefits of statin therapy for cerebral small vessel disease (CSVD), particularly in adults ≥75 years of age, have not been fully evaluated. Methods We analyzed the data from a prospective population-based cohort study and a randomized, double-blind, placebo-controlled clinical trial to determine whether statin therapy might aid in slowing the progression of CSVD in adults ≥75 years of age. For the cohort study, 827 participants were considered eligible and were included in the baseline analysis. Subsequently, 781 participants were included in follow-up analysis. For the clinical trial, 227 participants were considered eligible and were used in the baseline and follow-up analyses. Results The white matter hyperintensities (WMH) volume, the WMH-to-intracranial volume (ICV) ratio, the prevalence of a Fazekas scale score ≥ 2, lacunes, enlarged perivascular spaces (EPVS), and microbleeds were significantly lower in the statin group than the non-statin group at baseline in the cohort study (all P < 0.05). During the follow-up period, in both the cohort and clinical trial studies, the WMH volume and WMH-to-ICV ratio were significantly lower in the statin/rosuvastatin group than the non-statin/placebo group (all P < 0.001). Statin therapy was associated with lower risk of WMH, lacunes, and EPVS progression than the non-statin therapy group after adjustment for confounders (all P < 0.05). There was no statistically significant difference in the risk of microbleeds between the statin and non-statin therapy groups (all, P > 0.05). Conclusions Our findings indicated that statin therapy alleviated the progression of WMH, lacunes, and EPVS without elevating the risk of microbleeds. On the basis of the observed results, we concluded that statin therapy is an efficient and safe intervention for CSVD in adults ≥75 years of age. Trial registration Chictr.org.cn: ChiCTR-IOR-17013557 , date of trial retrospective registration November 27, 2017 and ChiCTR-EOC-017013598 , date of trial retrospective registration November 29, 2017. |
| first_indexed | 2024-12-12T14:10:28Z |
| format | Article |
| id | doaj.art-2872c9487ad441afb72f6a6e32bbca84 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-12T14:10:28Z |
| publishDate | 2020-08-01 |
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| series | BMC Geriatrics |
| spelling | doaj.art-2872c9487ad441afb72f6a6e32bbca842022-12-22T00:22:06ZengBMCBMC Geriatrics1471-23182020-08-0120111310.1186/s12877-020-01682-wAssessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of ageYuqi Guo0Yunpeng Li1Xukui Liu2Yi Cui3Yingxin Zhao4Shangwen Sun5Qing Jia6Qiang Chai7Gary Gong8Hua Zhang9Zhendong Liu10Basic Medical College, Shandong First Medical UniversitySchool of Medicine and Life Sciences, Shandong First Medical UniversitySchool of Medicine and Life Sciences, Shandong First Medical UniversityDepartment of Radiology, Shandong University Qilu HospitalBasic Medical College, Shandong First Medical UniversityBasic Medical College, Shandong First Medical UniversityBasic Medical College, Shandong First Medical UniversityBasic Medical College, Shandong First Medical UniversityThe Russel H. Morgan Department of Radiology and Radiological Sciences, the Johns Hopkins University School of MedicineBasic Medical College, Shandong First Medical UniversityBasic Medical College, Shandong First Medical UniversityAbstract Background Statins have been recommended by several guidelines as the primary prevention medication for cardiovascular diseases. However, the benefits of statin therapy for cerebral small vessel disease (CSVD), particularly in adults ≥75 years of age, have not been fully evaluated. Methods We analyzed the data from a prospective population-based cohort study and a randomized, double-blind, placebo-controlled clinical trial to determine whether statin therapy might aid in slowing the progression of CSVD in adults ≥75 years of age. For the cohort study, 827 participants were considered eligible and were included in the baseline analysis. Subsequently, 781 participants were included in follow-up analysis. For the clinical trial, 227 participants were considered eligible and were used in the baseline and follow-up analyses. Results The white matter hyperintensities (WMH) volume, the WMH-to-intracranial volume (ICV) ratio, the prevalence of a Fazekas scale score ≥ 2, lacunes, enlarged perivascular spaces (EPVS), and microbleeds were significantly lower in the statin group than the non-statin group at baseline in the cohort study (all P < 0.05). During the follow-up period, in both the cohort and clinical trial studies, the WMH volume and WMH-to-ICV ratio were significantly lower in the statin/rosuvastatin group than the non-statin/placebo group (all P < 0.001). Statin therapy was associated with lower risk of WMH, lacunes, and EPVS progression than the non-statin therapy group after adjustment for confounders (all P < 0.05). There was no statistically significant difference in the risk of microbleeds between the statin and non-statin therapy groups (all, P > 0.05). Conclusions Our findings indicated that statin therapy alleviated the progression of WMH, lacunes, and EPVS without elevating the risk of microbleeds. On the basis of the observed results, we concluded that statin therapy is an efficient and safe intervention for CSVD in adults ≥75 years of age. Trial registration Chictr.org.cn: ChiCTR-IOR-17013557 , date of trial retrospective registration November 27, 2017 and ChiCTR-EOC-017013598 , date of trial retrospective registration November 29, 2017.http://link.springer.com/article/10.1186/s12877-020-01682-wStatinsNeuroprotectionCerebral small vessel diseaseAging |
| spellingShingle | Yuqi Guo Yunpeng Li Xukui Liu Yi Cui Yingxin Zhao Shangwen Sun Qing Jia Qiang Chai Gary Gong Hua Zhang Zhendong Liu Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age BMC Geriatrics Statins Neuroprotection Cerebral small vessel disease Aging |
| title | Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age |
| title_full | Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age |
| title_fullStr | Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age |
| title_full_unstemmed | Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age |
| title_short | Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age |
| title_sort | assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age |
| topic | Statins Neuroprotection Cerebral small vessel disease Aging |
| url | http://link.springer.com/article/10.1186/s12877-020-01682-w |
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