Stroke Unit, Department of Neurology Girona Biomedical Research Institute(IDIBGI), Dr Josep Trueta University Hospital, Girona, Spain.
Interventional Neuroradiology Unit, Department of Neurosciences, Germans Trias i Pujol University Hospital, Badalona, Spain.
PLoS One. 2021 Feb 18;16(2):e0247153. doi: 10.1371/journal.pone.0247153. eCollection 2021.
Acetylsalicylic acid (ASA) and statins have been identified as potentially reducing the risk of intracranial aneurysms (IA) rupture. We aim to determine the effect of this drugs on the risk of rupture of IA.
We performed a retrospective cohort study from a prospective database of patients with IA treated in our institution between January 2013 and December 2018. Demographics, previous oral treatments, presence of multiple aneurysms, size of aneurysm, lobulation, location and morphology of the aneurysms were recorded. Patients were dichotomized as ruptured and unruptured IA.
A total of 408 IA were treated, of which 283 (68.6%) were in women. The median age was 53, 194 (47.5%) were ruptured IA. 38 patients (9.3%) were receiving ASA and 84 (20.6%) were receiving statins at the moment of the IA diagnosis. In the multivariable regression analysis, ASA plus statin use and multiple aneurysms were independently associated with unruptured IA (OR 5.01, 95% CI, 1.37-18.33, P = 0.015 and OR 2.72, 95% CI 1.68-4.27, P<0.001, respectively). Whereas, lobulated wall aneurysm and PComA/AComA location were inversely and independently associated with unruptured IA condition (OR 0.34, 95% CI 0.21-0.55, P<0.001 and OR 0.37, 95% CI 0.23-0.60, P<0.001, respectively). However, ASA and statins in monotherapy were not independently associated with unruptured IA condition.
In our study population ASA plus statins treatment is independently associated with unruptured IA. Larger and prospective studies are required to explore this potential protective effect against IA rupture.
乙酰水杨酸（ASA）和他汀类药物已被确定为可能降低颅内动脉瘤（IA）破裂风险的药物。我们旨在确定这些药物对 IA 破裂风险的影响。
我们进行了一项回顾性队列研究，该研究来自 2013 年 1 月至 2018 年 12 月期间在我们机构治疗的 IA 患者的前瞻性数据库。记录了人口统计学、既往口服治疗、多发性动脉瘤、动脉瘤大小、分叶、位置和形态。将患者分为破裂和未破裂的 IA。
共治疗了 408 个 IA，其中 283 个（68.6%）为女性。中位年龄为 53 岁，194 个（47.5%）为破裂的 IA。诊断为 IA 时，38 例（9.3%）正在服用 ASA，84 例（20.6%）正在服用他汀类药物。多变量回归分析显示，ASA 加他汀类药物的使用和多发性动脉瘤与未破裂的 IA 独立相关（OR 5.01，95%CI，1.37-18.33，P = 0.015 和 OR 2.72，95%CI 1.68-4.27，P<0.001，分别）。然而，分叶状壁动脉瘤和 PComA/AComA 位置与未破裂的 IA 状况呈反比且独立相关（OR 0.34，95%CI 0.21-0.55，P<0.001 和 OR 0.37，95%CI 0.23-0.60，P<0.001，分别）。然而，ASA 和他汀类药物单药治疗与未破裂的 IA 状况无关。
在我们的研究人群中，ASA 加他汀类药物治疗与未破裂的 IA 独立相关。需要更大规模的前瞻性研究来探索这种对 IA 破裂的潜在保护作用。
