Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany.
Eur Stroke J. 2023 Mar;8(1):251-258. doi: 10.1177/23969873221129080. Epub 2022 Oct 7.
Previous medical history strongly contributes to the genesis of intracranial aneurysms (IA). A possible impact of regular medication on the occurrence of abdominal aortic aneurysms has been reported.
To evaluate the value of regular medication on the risk of development and rupture of IA.
Data on medication use and related comorbidities were obtained from the institutional IA registry. A 1:1 age- and sex-matched patient sample was collected from the population-based Heinz Nixdorf Recall Study with individuals from the same area.
In the analysis comparing IA cohort ( = 1960) with the matched normal population ( = 1960), the use of statins (adjusted odds ratio, 1.34 [95% confidence interval 1.02-1.78]), antidiabetics (1.46 [1.08-1.99]), and calcium channel blockers (1.49 [1.11-2.00]) was independently associated with higher risk of IA, whereas uricostatics (0.23 [0.14-0.38]), aspirin (0.23 [0.13-0.43]), beta-blockers (0.51 [0.40-0.66]), and angiotensin-converting enzyme inhibitors (0.38 [0.27-0.53]) were related to lower risk of IA. In the multivariable analysis within the IA cohort ( = 2446), SAH patients showed higher drug exposure with thiazide diuretics (2.11 [1.59-2.80]), but lower prevalence of remaining antihypertensive medication-beta-blockers (0.38 [0.30-0.48]), calcium channel blockers (0.63 [0.48-0.83]), angiotensin-converting enzyme inhibitors (0.56 [0.44-0.72]), and angiotensin-1 receptor blockers (0.33 [0.24-0.45]). Patients with ruptured IA were less likely to be treated with statins (0.62 [0.47-0.81]), thyroid hormones (0.62 [0.48-0.79]), and aspirin (0.55 [0.41-0.75]).
Regular medication might impact the risks related to the development and rupture of IA. Further clinical trials are required to clarify the effect of regular medication on IA genesis.
既往病史对颅内动脉瘤（IA）的发生有重要影响。有研究报道，常规用药可能对腹主动脉瘤的发生有一定影响。
评估常规用药对 IA 发展和破裂风险的影响。
从机构性 IA 登记处获取用药情况和相关合并症的数据。从基于人群的 Heinz Nixdorf 召回研究中按年龄和性别 1:1 匹配患者样本，个体来自同一地区。
在比较 IA 队列（n=1960）和匹配的正常人群（n=1960）的分析中，使用他汀类药物（调整后的优势比，1.34[95%置信区间 1.02-1.78]）、抗糖尿病药物（1.46[1.08-1.99]）和钙通道阻滞剂（1.49[1.11-2.00]）与 IA 风险增加独立相关，而尿酸盐生成抑制剂（0.23[0.14-0.38]）、阿司匹林（0.23[0.13-0.43]）、β受体阻滞剂（0.51[0.40-0.66]）和血管紧张素转换酶抑制剂（0.38[0.27-0.53]）与 IA 风险降低相关。在 IA 队列的多变量分析中（n=2446），蛛网膜下腔出血患者使用噻嗪类利尿剂的药物暴露率更高（2.11[1.59-2.80]），但其余降压药物β受体阻滞剂（0.38[0.30-0.48]）、钙通道阻滞剂（0.63[0.48-0.83]）、血管紧张素转换酶抑制剂（0.56[0.44-0.72]）和血管紧张素 1 受体阻滞剂（0.33[0.24-0.45]）的使用率较低。破裂性 IA 患者更不可能接受他汀类药物（0.62[0.47-0.81]）、甲状腺激素（0.62[0.48-0.79]）和阿司匹林（0.55[0.41-0.75]）治疗。
常规用药可能会影响 IA 发展和破裂的相关风险。需要进一步的临床试验来阐明常规用药对 IA 发生的影响。
