A single-center pilot randomized controlled trial of atorvastatin loading for preventing ischemic brain damage after carotid artery stenting

Wang, Haipeng and Wang, Junjie and Qi, Peng and Yang, Ximeng and Chen, Kunpeng and Hu, Shen and Liu, Erteng and Zhang, Shun and Gao, Qun and Li, Rui and Lu, Jun and Deng, Gang and Wang, Daming (2022) A single-center pilot randomized controlled trial of atorvastatin loading for preventing ischemic brain damage after carotid artery stenting. Frontiers in Aging Neuroscience, 14. ISSN 1663-4365

[thumbnail of pubmed-zip/versions/1/package-entries/fnagi-14-1066316/fnagi-14-1066316.pdf] Text
pubmed-zip/versions/1/package-entries/fnagi-14-1066316/fnagi-14-1066316.pdf - Published Version

Download (2MB)

Abstract

Objective: Carotid artery stenting (CAS) performed perioperatively with high-dose atorvastatin may reduce the incidence of new ischemic brain lesions, but more high-level evidence is needed. Furthermore, the optimal dose and course of perioperative statin therapy remain uncertain.

Methods: A single-center, prospective, parallel controlled, pilot randomized clinical trial was conducted at Beijing Hospital. The study includes a total of 130 patients with CAS. The patients were randomly assigned to receive a high-dose of 80 mg/day atorvastatin (n = 65) or a standard-dose of 20 mg/day atorvastatin (n = 65) 3 days before and 3 days after planned CAS. The primary endpoint event was the cumulative incidence of silent new ischemic cerebral lesions (sNICL) on post-CAS cerebral diffusion-weighted magnetic resonance imaging (DW-MRI), transient ischemic attack (TIA), or ischemic stroke within 30 days after CAS.

Results: Among the 130 patients, 123 completed the study, of which 63 were in the high-dose group and 60 were in the standard-dose group. The incidence of major endpoint events was 69.8% (44 cases) and 78.3% (46 cases) in the high-dose and standard-dose groups, respectively. There was no significant difference between the two groups (HR, 0.705; 95% CI, 0.315–1.576; p = 0.393). According to the stratified analysis results, the sNICL incidence was significantly different between the two groups in the symptomatic patients (HR, 0.263; 95% CI, 0.70–0.984; p = 0.04).

Conclusion: Among patients with CAS, a periprocedural high-dose of atorvastatin did not reduce the rate of periprocedural ischemic brain damage. However, high-dose statins can reduce the incidence of sNICL after CAS in patients with symptomatic carotid stenosis.

Clinical Trial Registration: Clinicaltrials.gov, identifier NCT03079115.

Item Type: Article
Subjects: Bengali Archive > Medical Science
Depositing User: Unnamed user with email support@bengaliarchive.com
Date Deposited: 14 Jul 2023 11:46
Last Modified: 26 Jun 2024 11:16
URI: http://science.archiveopenbook.com/id/eprint/1664

Actions (login required)

View Item
View Item