Bleeding Risk of Cerebral Cavernous Malformations in Patients on Statin and Antiplatelet Medication: A Cohort Study.
Options
BORIS DOI
Publisher DOI
PubMed ID
36999926
Description
BACKGROUND
Statin medication has been identified as a potential therapeutic target for stabilizing cerebral cavernous malformations (CCMs). Although increasing evidence suggests that antiplatelet medication decreases the risk of CCM hemorrhage, data on statin medication in clinical studies are scarce.
OBJECTIVE
To assess the risk of symptomatic CCM-related hemorrhage at presentation and during follow-up in patients on statin and antiplatelet medication.
METHODS
A single-center database containing patients harboring CCMs was retrospectively analyzed over 41 years and interrogated for symptomatic hemorrhage at diagnosis, during follow-up, and statin and antiplatelet medication.
RESULTS
In total, 212 of 933 CCMs (22.7%), harbored by 688 patients, presented with hemorrhage at diagnosis. Statin medication was not associated with a decreased risk of hemorrhage at diagnosis (odds ratio [OR] 0.63, CI 0.23-1.69, P = .355); antiplatelet medication (OR 0.26, CI 0.08-0.86, P = .028) and combined statin and antiplatelet medication (OR 0.19, CI 0.05-0.66; P = .009) showed a decreased risk. In the antiplatelet-only group, 2 (4.7%) of 43 CCMs developed follow-up hemorrhage during 137.1 lesion-years compared with 67 (9.5%) of 703 CCMs during 3228.1 lesion-years in the nonmedication group. No follow-up hemorrhages occurred in the statin and the combined statin and antiplatelet medication group. Antiplatelet medication was not associated with follow-up hemorrhage (hazard ratio [HR] 0.7, CI 0.16-3.05; P = .634).
CONCLUSION
Antiplatelet medication alone and its combination with statins were associated with a lower risk of hemorrhage at CCM diagnosis. The risk reduction of combined statin and antiplatelet medication was greater than in patients receiving antiplatelet medication alone, indicating a possible synergistic effect. Antiplatelet medication alone was not associated with follow-up hemorrhage.
Statin medication has been identified as a potential therapeutic target for stabilizing cerebral cavernous malformations (CCMs). Although increasing evidence suggests that antiplatelet medication decreases the risk of CCM hemorrhage, data on statin medication in clinical studies are scarce.
OBJECTIVE
To assess the risk of symptomatic CCM-related hemorrhage at presentation and during follow-up in patients on statin and antiplatelet medication.
METHODS
A single-center database containing patients harboring CCMs was retrospectively analyzed over 41 years and interrogated for symptomatic hemorrhage at diagnosis, during follow-up, and statin and antiplatelet medication.
RESULTS
In total, 212 of 933 CCMs (22.7%), harbored by 688 patients, presented with hemorrhage at diagnosis. Statin medication was not associated with a decreased risk of hemorrhage at diagnosis (odds ratio [OR] 0.63, CI 0.23-1.69, P = .355); antiplatelet medication (OR 0.26, CI 0.08-0.86, P = .028) and combined statin and antiplatelet medication (OR 0.19, CI 0.05-0.66; P = .009) showed a decreased risk. In the antiplatelet-only group, 2 (4.7%) of 43 CCMs developed follow-up hemorrhage during 137.1 lesion-years compared with 67 (9.5%) of 703 CCMs during 3228.1 lesion-years in the nonmedication group. No follow-up hemorrhages occurred in the statin and the combined statin and antiplatelet medication group. Antiplatelet medication was not associated with follow-up hemorrhage (hazard ratio [HR] 0.7, CI 0.16-3.05; P = .634).
CONCLUSION
Antiplatelet medication alone and its combination with statins were associated with a lower risk of hemorrhage at CCM diagnosis. The risk reduction of combined statin and antiplatelet medication was greater than in patients receiving antiplatelet medication alone, indicating a possible synergistic effect. Antiplatelet medication alone was not associated with follow-up hemorrhage.
Date of Publication
2023-09-01
Publication Type
Article
Subject(s)
Language(s)
en
Contributor(s)
Marques, Luca Lee | |
Jaeggi, Christian | |
Series
Neurosurgery
Publisher
Lippincott Williams & Wilkins
ISSN
0148-396X
Access(Rights)
restricted