Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age

作者：Yuqi Guo, Yunpeng Li, Xukui Liu, Yi Cui, Yingxin Zhao, Shangwen Sun, Qing Jia, Qiang Chai, Gary Gong, Hua Zhang, Zhendong Liu · 发表于：BMC Geriatrics · 年份：2020 · DOI：10.1186/s12877-020-01682-w · 被引用次数：40 · 研究领域：Cerebrospinal fluid and hydrocephalus、Intracerebral and Subarachnoid Hemorrhage Research、Cerebral Venous Sinus Thrombosis

BACKGROUND: Statins have been recommended by several guidelines as the primary prevention medication for cardiovascular diseases. However, the benefits of statin therapy for cerebral small vessel disease (CSVD), particularly in adults ≥75 years of age, have not been fully evaluated. METHODS: We analyzed the data from a prospective population-based cohort study and a randomized, double-blind, placebo-controlled clinical trial to determine whether statin therapy might aid in slowing the progression of CSVD in adults ≥75 years of age. For the cohort study, 827 participants were considered eligible and were included in the baseline analysis. Subsequently, 781 participants were included in follow-up analysis. For the clinical trial, 227 participants were considered eligible and were used in the baseline and follow-up analyses. RESULTS: The white matter hyperintensities (WMH) volume, the WMH-to-intracranial volume (ICV) ratio, the prevalence of a Fazekas scale score ≥ 2, lacunes, enlarged perivascular spaces (EPVS), and microbleeds were significantly lower in the statin group than the non-statin group at baseline in the cohort study (all P < 0.05). During the follow-up period, in both the cohort and clinical trial studies, the WMH volume and WMH-to-ICV ratio were significantly lower in the statin/rosuvastatin group than the non-statin/placebo group (all P < 0.001). Statin therapy was associated with lower risk of WMH, lacunes, and EPVS progression than the non-statin therapy group ...