Statin treatment intensity and cerebral vasomotor reactivity response in patients with ischemic stroke

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY Journal of Neuroimaging Pub Date : 2024-04-08 DOI:10.1111/jon.13200

Behnam Sabayan, Amirhossein Akhavan Sigari, Royya Modir, Brett C. Meyer, Thomas Hemmen, Dawn Meyer, Reza Bavarsad Shahripour

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Abstract

Background and Purpose

Cerebral vasomotor reactivity (VMR) is vital for regulating brain blood flow and maintaining neurological function. Impaired cerebral VMR is linked to a higher risk of stroke and poor post-stroke outcomes. This study explores the relationship between statin treatment intensity and VMR in patients with ischemic stroke.

Methods

Seventy-four consecutive patients (mean age 69.3 years, 59.4% male) with recent ischemic stroke were included. VMR levels were assessed 4 weeks after the index stroke using transcranial Doppler, measuring the breath-holding index (BHI) as an indicator of the percentage increase in middle cerebral artery blood flow (higher BHI signifies higher VMR). Multistep multivariable regression models, adjusted for demographic and cerebrovascular risk factors, were employed to examine the association between statin intensity treatment and BHI levels.

Results

Forty-one patients (55%) received high-intensity statins. Patients receiving high-intensity statins exhibited a mean BHI of 0.85, whereas those on low-intensity statins had a mean BHI of 0.67 (mean difference 0.18, 95% confidence interval: 0.13-0.22, p-value<.001). This significant difference persisted in the fully adjusted model (adjusted mean values: 0.84 vs. 0.68, p-value: .008). No significant differences were observed in BHI values within patient groups on high-intensity or low-intensity statin therapy (all p-values>.05). Furthermore, no significant association was found between baseline low-density lipoprotein (LDL) levels and BHI.

Conclusions

High-intensity statin treatment post-ischemic stroke is linked to elevated VMR independent of demographic and clinical characteristics, including baseline LDL level. Further research is needed to explore statin therapy's impact on preserving brain vascular function beyond lipid-lowering effects.

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他汀类药物治疗强度与缺血性脑卒中患者的脑血管运动反应性反应

背景和目的脑血管运动反应性（VMR）对调节脑血流和维持神经功能至关重要。脑血管运动反应性受损与中风风险升高和中风后预后不良有关。本研究探讨了他汀类药物治疗强度与缺血性脑卒中患者 VMR 之间的关系。方法连续纳入 74 名近期发生缺血性脑卒中的患者（平均年龄 69.3 岁，59.4% 为男性）。在中风发生 4 周后使用经颅多普勒评估 VMR 水平，测量屏气指数（BHI）作为大脑中动脉血流增加百分比的指标（BHI 越高表示 VMR 越高）。结果41名患者（55%）接受了高强度他汀类药物治疗。接受高强度他汀治疗的患者的平均 BHI 为 0.85，而接受低强度他汀治疗的患者的平均 BHI 为 0.67（平均差异为 0.18，95% 置信区间：0.13-0.22，P 值<.001）。在完全调整模型中，这一显著差异依然存在（调整后的平均值：0.84 vs. 0.68，p 值：.008）。在接受高强度或低强度他汀类药物治疗的患者组中，BHI 值无明显差异（所有 p 值均为 0.05）。结论缺血性卒中后高强度他汀治疗与 VMR 升高有关，与人口统计学和临床特征（包括基线低密度脂蛋白水平）无关。除降脂作用外，他汀类药物治疗对保护脑血管功能的影响还需进一步研究。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!