EFFECT OF SIMVASTATIN ON THE PROGNOSIS AND THE CHANGES OF THE CLINICAL STATUS IN PATIENTS WITH ACUTE ISCHEMIC STROKE. THE RESULTS OF THE 12 MONTH RANDOMIZED, OPEN COMPARATIVE STUDY

• Main Authors: V. V. Yakusevich, A. Yu. Malygin, A. V. Kabanov
• Format: Article
• Language: English
• Published: Stolichnaya Izdatelskaya Kompaniya 2015-09-01
• Series: Racionalʹnaâ Farmakoterapiâ v Kardiologii
• Subjects: ischemic stroke; simvastatin; forecast; neurological status; endothelial dysfunction
• Online Access: https://www.rpcardio.com/jour/article/view/83
• ISSN: 1819-6446; 2225-3653

Aim. To evaluate in open 12 month prospective, randomized study the mortality and recurrent cardiovascular events rate, dynamics of neurological deficit, endothelial dysfunc- tion and renal function in patients with the first ischemic stroke of hemispheric localization after prescription of simvastatin 40 mg daily in the acute stage of the disease. Material and methods. Patients (n=210) above 18 years of age (95 men and 115 women) with acute ischemic stroke were included into the study. Patients were randomized into two groups. Patients of the group 1 (n=105) received standard treatment for ischemic stroke. Patients of the group 2 (n=105) received simvastatin 40 mg/day additional- ly to standard therapy of stroke. Follow-up duration was 12 months. The lipid profile, a number of desquamated epithelial cells circulating in the blood, glomerular filtration rate (GFR) according to MDRD, as well as neurological patient status (Scandinavian Scale, MMSE, NIHSS) were monitored.Results. During the follow-up period mortality was 18.1% and 15.2% in group 1 and 2, respectively. Composite end point was achieved in 60.9% and 46.6% of patients, re- spectively (p=0.037). Lipid profile did not change significantly in group 1 while patients in group 2 showed a significant decrease in lipid levels. The positive dynamics of neuro- logical status was observed in both groups, however, the most significant - in group 2. Reduction in a number of endothelial desquamated cells was 45.7% in group 2 and 13.3% in group 1 (p=0.00001). GFR increased significantly in patients of group 2.Conclusion. The long-term treatment with simvastatin in combination with neuroprotective and antihypertensive therapy in patients with acute ischemic stroke leads to decrease in the incidence rate of clinically relevant events, improvement of endothelial function, neurological status and prognosis.