Could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real-world setting?
Background: Several pharmacological pathways have revealed statin to have a positive role in patients with for intracranial aneurysms. However, prior studies regarding the association between statin use and patients’ outcomes after pipeline embolization device (PED) treatment were not completely sup...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-05-01
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| Series: | Therapeutic Advances in Neurological Disorders |
| Online Access: | https://doi.org/10.1177/17562864231170517 |
| _version_ | 1797829797068406784 |
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| author | Xinrui Wang Mirzat Turhon Xinjian Yang Jianmin Liu Hongqi Zhang Tianxiao Li Donglei Song Yuanli Zhao Sheng Guan Aisha Maimaitili Yunyan Wang Wenfeng Feng Jieqing Wan Guohua Mao Huaizhang Shi Zhuoling An Yang Wang |
| author_facet | Xinrui Wang Mirzat Turhon Xinjian Yang Jianmin Liu Hongqi Zhang Tianxiao Li Donglei Song Yuanli Zhao Sheng Guan Aisha Maimaitili Yunyan Wang Wenfeng Feng Jieqing Wan Guohua Mao Huaizhang Shi Zhuoling An Yang Wang |
| author_sort | Xinrui Wang |
| collection | DOAJ |
| description | Background: Several pharmacological pathways have revealed statin to have a positive role in patients with for intracranial aneurysms. However, prior studies regarding the association between statin use and patients’ outcomes after pipeline embolization device (PED) treatment were not completely supportive. Objectives: To investigate whether statin medication following PED treatment would improve the outcomes of intracranial aneurysm patients in a real-world setting. Design: A retrospective multicenter cohort study. Methods: Patients were selected from the PLUS registry study conducted from November 2014 to October 2019 across 14 centers in China. The population was divided into two groups: those who received statin medication after the PED treatment and those who did not receive statin medication after PED treatment. Study outcomes included angiographic evaluation of aneurysm occlusion, parent arteries stenosis, ischemic and hemorrhage complications, all-cause mortality, neurologic mortality, and functional outcome. Results: 1087 patients with 1168 intracranial aneurysms were eligible; 232 patients were in the statin user group and the other 855 were in the non-statin user group. For the statin user group versus the non-statin user group, no significant difference was found for the primary outcomes of complete occlusion of aneurysm (82.4% versus 84.2%; p = 0.697). Of the secondary outcomes, none had a significant difference including stenosis of parent arteries ≥ 50% (1.4% versus 2.3%; p = 0.739), total subarachnoid hemorrhage (0.9% versus 2.5%; p = 0.215), all-cause mortality (0.0% versus 1.9%; p = 0.204), neurologic mortality (0.0% versus 1.6%; p = 0.280), excellent (95.5% versus 97.2%; p = 0.877), and favorable (98.9% versus 98.4%; p = 0.933) functional outcomes. The total ischemic complication rate (9.0% versus 7.1%; p = 0.401) was higher but not significant in the statin user group. The propensity score-matched cohort showed similar results. Results of binary multivariable logistic regression analysis and propensity score-matched analysis both showed that statin usage was not independently associated with an increased rate of complete occlusion or any other secondary outcomes. Subgroup analysis found the same result in patients who did not use statin before the procedure. Conclusion: Among patients with intracranial aneurysms, statin use after the PED treatment was not significantly associated with better angiographic and clinical outcomes. Well-designed studies are needed to further confirm this finding. |
| first_indexed | 2024-04-09T13:25:56Z |
| format | Article |
| id | doaj.art-f99e1b1ac46f444789488161710c3185 |
| institution | Directory Open Access Journal |
| issn | 1756-2864 |
| language | English |
| last_indexed | 2024-04-09T13:25:56Z |
| publishDate | 2023-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Neurological Disorders |
| spelling | doaj.art-f99e1b1ac46f444789488161710c31852023-05-10T11:37:40ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642023-05-011610.1177/17562864231170517Could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real-world setting?Xinrui WangMirzat TurhonXinjian YangJianmin LiuHongqi ZhangTianxiao LiDonglei SongYuanli ZhaoSheng GuanAisha MaimaitiliYunyan WangWenfeng FengJieqing WanGuohua MaoHuaizhang ShiZhuoling AnYang WangBackground: Several pharmacological pathways have revealed statin to have a positive role in patients with for intracranial aneurysms. However, prior studies regarding the association between statin use and patients’ outcomes after pipeline embolization device (PED) treatment were not completely supportive. Objectives: To investigate whether statin medication following PED treatment would improve the outcomes of intracranial aneurysm patients in a real-world setting. Design: A retrospective multicenter cohort study. Methods: Patients were selected from the PLUS registry study conducted from November 2014 to October 2019 across 14 centers in China. The population was divided into two groups: those who received statin medication after the PED treatment and those who did not receive statin medication after PED treatment. Study outcomes included angiographic evaluation of aneurysm occlusion, parent arteries stenosis, ischemic and hemorrhage complications, all-cause mortality, neurologic mortality, and functional outcome. Results: 1087 patients with 1168 intracranial aneurysms were eligible; 232 patients were in the statin user group and the other 855 were in the non-statin user group. For the statin user group versus the non-statin user group, no significant difference was found for the primary outcomes of complete occlusion of aneurysm (82.4% versus 84.2%; p = 0.697). Of the secondary outcomes, none had a significant difference including stenosis of parent arteries ≥ 50% (1.4% versus 2.3%; p = 0.739), total subarachnoid hemorrhage (0.9% versus 2.5%; p = 0.215), all-cause mortality (0.0% versus 1.9%; p = 0.204), neurologic mortality (0.0% versus 1.6%; p = 0.280), excellent (95.5% versus 97.2%; p = 0.877), and favorable (98.9% versus 98.4%; p = 0.933) functional outcomes. The total ischemic complication rate (9.0% versus 7.1%; p = 0.401) was higher but not significant in the statin user group. The propensity score-matched cohort showed similar results. Results of binary multivariable logistic regression analysis and propensity score-matched analysis both showed that statin usage was not independently associated with an increased rate of complete occlusion or any other secondary outcomes. Subgroup analysis found the same result in patients who did not use statin before the procedure. Conclusion: Among patients with intracranial aneurysms, statin use after the PED treatment was not significantly associated with better angiographic and clinical outcomes. Well-designed studies are needed to further confirm this finding.https://doi.org/10.1177/17562864231170517 |
| spellingShingle | Xinrui Wang Mirzat Turhon Xinjian Yang Jianmin Liu Hongqi Zhang Tianxiao Li Donglei Song Yuanli Zhao Sheng Guan Aisha Maimaitili Yunyan Wang Wenfeng Feng Jieqing Wan Guohua Mao Huaizhang Shi Zhuoling An Yang Wang Could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real-world setting? Therapeutic Advances in Neurological Disorders |
| title | Could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real-world setting? |
| title_full | Could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real-world setting? |
| title_fullStr | Could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real-world setting? |
| title_full_unstemmed | Could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real-world setting? |
| title_short | Could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real-world setting? |
| title_sort | could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real world setting |
| url | https://doi.org/10.1177/17562864231170517 |
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