Vitturi Bruno Kusznir, Gagliardi Rubens José
Department of Neurology, Santa Casa de São Paulo School of Medical Sciences, Dr. Cesário Motta Júnior Street 112, São Paulo, 01221-020, Brazil.
Neurol Sci. 2020 Jul;41(7):1851-1857. doi: 10.1007/s10072-020-04298-5. Epub 2020 Feb 21.
Currently, statins are widely used for secondary prevention of stroke due to their pleiotropic neuroprotective effects. Epilepsy is a common complication of cerebrovascular diseases. The purpose of this study was to evaluate the effect of statin therapy on the occurrence of post-stroke epilepsy (PSE).
In this prospective cohort study, patients who suffered an ischemic stroke and without history of epilepsy before stroke were enrolled. At baseline, patients were classified according to the particularities of statin therapy. Statin use onset and adherence to treatment were registered as well. After a follow-up period of 1 year, we assessed the occurrence of seizures and PSE.
Among the 477 patients included in our cohort, there were 91 (19.1%) patients without statins, 160 (33.5%) with simvastatin 20 mg, 180 (37.7%) with simvastatin 40 mg, and 46 (9.6%) with high-potency statins. Overall, PSE emerged in 53 (11.1%) patients. PSE was significantly more prevalent among those who did not receive statins and those with lower doses of simvastatin. Acute onset of statin use was associated with reduced odds of having PSE.
Adequate treatment with statins after stroke may lower the risk of PSE.
目前,他汀类药物因其多效性神经保护作用而被广泛用于中风的二级预防。癫痫是脑血管疾病的常见并发症。本研究的目的是评估他汀类药物治疗对中风后癫痫(PSE)发生的影响。
在这项前瞻性队列研究中,纳入了缺血性中风且中风前无癫痫病史的患者。在基线时,根据他汀类药物治疗的特殊性对患者进行分类。记录他汀类药物的使用起始时间和治疗依从性。经过1年的随访期后,我们评估了癫痫发作和PSE的发生情况。
在我们队列中的477例患者中,91例(19.1%)未使用他汀类药物,160例(33.5%)使用辛伐他汀20mg,180例(37.7%)使用辛伐他汀40mg,46例(9.6%)使用高效能他汀类药物。总体而言,53例(11.1%)患者出现了PSE。PSE在未接受他汀类药物治疗的患者和使用较低剂量辛伐他汀的患者中明显更为普遍。他汀类药物的急性起始使用与发生PSE的几率降低相关。
中风后使用他汀类药物进行充分治疗可能会降低PSE的风险。