Journal article
The association of statin therapy with reduced intracranial aneurysm recurrence after endovascular coiling: a post hoc propensity score-matched analysis of a randomized clinical trial
Journal of neurosurgery, v 142(5), pp 1-10
20 Dec 2024
PMID: 39705700
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Endovascular intracranial aneurysm (IA) management has significantly evolved over the last 2 decades. Despite these advancements, the aneurysm recanalization rate after coil embolization remains a concern. Statins have been found to affect vascular repair and remodeling; therefore, the authors hypothesized that patients receiving statin therapy at the time of coil embolization would have lower aneurysm recurrence and retreatment rates compared with patients not receiving statin therapy.
A post hoc analysis was conducted of the primary data from patients enrolled in the Hydrogel Endovascular Aneurysm Treatment Trial focusing on the impact of statin use on the recurrence rates of 3- to 14-mm IAs after endovascular coiling. The primary outcome measured included aneurysm recurrence over 18-24 months using the Raymond-Roy Occlusion Classification. Secondary outcomes included major and minor recurrence rates and retreatment rates. Propensity score matching based on patient and aneurysm characteristics was performed to mitigate selection bias.
A total of 577 patients with data on statin use were eligible for this analysis. Of these, 178 (30.8%) patients were using statins and 399 (69.2%) were not. After propensity score matching, 156 (39.2%) patients were included in the statin group and 242 (60.8%) in the nonstatin group. The recurrence rate was 3.8% (6/156) in the statin group and 10.7% (26/242) in the nonstatin group (p = 0.013). In a subgroup analysis, statin use significantly reduced recurrence in patients with unruptured aneurysms (1.6% vs 9.7%, p = 0.005), but not in those with ruptured aneurysms (12.5% vs 13.6%, p = 0.876).
Statin use was associated with a reduced rate of aneurysm recurrence in patients who underwent endovascular coiling for IAs with a decreased rate of retreatment during the follow-up period. Statins are a relatively low-risk treatment and may be an effective therapy to reduce recanalization of IAs, although further prospective studies are warranted to validate these findings.
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Details
- Title
- The association of statin therapy with reduced intracranial aneurysm recurrence after endovascular coiling: a post hoc propensity score-matched analysis of a randomized clinical trial
- Creators
- Devi P Patra - Neurological SurgeryKarl R Abi-Aad - SUNY Upstate Medical UniversityEvelyn L Turcotte - Mayo Clinic in FloridaChristopher S Ogilvy - Beth Israel Deaconess Medical CenterElad I Levy - University at Buffalo, State University of New YorkAdnan H Siddiqui - University at Buffalo, State University of New YorkErol Veznedaroglu - Drexel UniversityH Hunt Batjer - The University of Texas Southwestern Medical CenterBernard R Bendok - Neurological Surgery
- Publication Details
- Journal of neurosurgery, v 142(5), pp 1-10
- Publisher
- American Association of Neurological Surgeons
- Number of pages
- 10
- Grant note
- MicroVention
The HEAT study was an investigator-initiated trial funded by MicroVention through a grant that was housed at Northwestern University and Mayo Clinic. This study was independently managed by the senior author (B.R.B.) . No funding was received for this post hoc analysis.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurosurgery
- Web of Science ID
- WOS:001488885700004
- Scopus ID
- 2-s2.0-105004276941
- Other Identifier
- 991022005690604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery