2013 Articles

Statins Reduce Neurologic Injury in Asymptomatic Carotid Endarterectomy Patients

Heyer, Eric J.; Mergeche, Joanna L.; Bruce, Samuel S.; Ward, Justin T.; Stern, Yaakov; Anastasian, Zirka H.; Quest, Donald O.; Solomon, Robert A.; Todd, George J.; Benvenisty, Alan I.; McKinsey, James F.; Nowygrod, Roman; Morrissey, Nicholas J.; Connolly, E. Sander

Background and Purpose—Statins are neuroprotective in a variety of experimental models of cerebral injury. We sought to determine whether patients taking statins before asymptomatic carotid endarterectomy exhibit a lower incidence of neurological injury (clinical stroke and cognitive dysfunction). Methods—A total of 328 patients with asymptomatic carotid stenosis scheduled for elective carotid endarterectomy consented to participate in this observational study of perioperative neurological injury. Results—Patients taking statins had a lower incidence of clinical stroke (0.0% vs 3.1%; P=0.02) and cognitive dysfunction (11.0% vs 20.2%; P=0.03). In a multivariate regression model, statin use was significantly associated with decreased odds of cognitive dysfunction (odds ratio, 0.51 [95% CI, 0.27–0.96]; P=0.04). Conclusions—Preoperative statin use was associated with less neurological injury after asymptomatic carotid endarterectomy. These observations suggest that it may be possible to further reduce the perioperative morbidity of carotid endarterectomy. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00597883   (Stroke. 2013;44: 1150-1152.)