Simvastatin efficacy in vasospasm treatment in patients after aneurysm SAH

: Number of trials had previously demonstrated cerebroprotective effect of statin therapy in SAH patients. Aim of the current study was to assess effects of simvastatin on vasospasm in clinical practice. The study group comprised 35 patients admitted to Burdenko Neurosurgery Institute with aneurysmal SAH in 2007-2011. All patients were treated with surgery within 14 days post-SAH and received simvastatin 40 mg/day. Mean age was 46,5 (16-69) years, male: female ratio - 20:15, Hunt-Hess scale breakdown: I - 7 (20%), II - 12 (34.3%), III - 11 (31.4%), IV - 4 (11.4%), V - 1 (2.8%). In 31 (88.6%) patients aneurysm was clipped, in 4 (11.4%)--coiled. Outcomes at discharge and at follow-up (modified Rankin scale), vasospasm dynamics, delayed ischemic neurological deficit (DIND), duration of hospital stay and number of home discharged patients were evaluated and analyzed in comparison to control group (n = 30). Statin group did not demonstrated valid difference in immediate and late outcomes (mean 20,5 month), risk of DIND, length of hospital stay and percentage of discharged home patients. Statin group showed significantly lower rates of vasospam progression--42.9% vs. 76.7% in control (chi2-test, p = 0.01). Our evidence corresponds with outcomes of international trials of statin application in SAH patients. As follows from our results and existing randomized and clinical trials data there is no strong evidence nowadays to recommend statin prescription in SAH patients.