No relationship of lipid-lowering agents to hematoma growth: pooled analysis of the intensive blood pressure reduction in acute cerebral hemorrhage trials studies

Stroke. 2015 Mar;46(3):857-9. doi: 10.1161/STROKEAHA.114.007664. Epub 2015 Feb 5.

Abstract

Background and purpose: Controversy persists over statins and risk of intracerebral hemorrhage. We determined associations of premorbid lipid-lowering therapy and outcomes among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT).

Methods: The pooled data of INTERACT 1 and 2 (international, multicenter, prospective, open, blinded end point, randomized controlled trials of patients with intracerebral hemorrhage [<6 hours] and elevated systolic blood pressure) were analyzed with regard to associations of baseline lipid-lowering treatment and clinical outcomes of 3184 participants in a multivariate model. Associations of lipid-lowering therapy and hematoma growth (baseline to 24 hours) in computed tomographic substudies participants (n=1310) were estimated in ANCOVA.

Results: Among 204 patients (6.5%) with baseline lipid-lowering treatment, 90-day clinical outcomes were not significantly different after adjustment for confounding variables including region and age. In the computed tomographic substudy, 24-hour hematoma growth was greater in 124 patients (9%) with, compared with those without, prior lipid-lowering therapy. However, this association was not significant between groups (9.2 versus 6.8 mL; P<0.13), after adjustment for prior antithrombotic therapy.

Conclusions: No independent associations were found between lipid-lowering medication and adverse outcomes in patients with intracerebral hemorrhage.

Clinical trial registration url: http://www.clinicaltrials.gov. Unique identifier: NCT00226096 and NCT00716079.

Keywords: cerebral hemorrhage; statins, HMG-CoA.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure
  • Brain / physiopathology
  • Cerebral Hemorrhage / blood*
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / diagnosis*
  • Data Interpretation, Statistical
  • Female
  • Hematoma / diagnostic imaging
  • Hematoma / drug therapy*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypertension / complications
  • International Cooperation
  • Lipids / blood*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Systole
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids

Associated data

  • ClinicalTrials.gov/NCT00226096
  • ClinicalTrials.gov/NCT00716079