J Cerebrovasc Endovasc Neurosurg.  2019 Sep;21(3):144-151. 10.7461/jcen.2019.21.3.144.

Regression of asymptomatic intracranial arterial stenosis by aggressive medical management with a lipid-lowering agent

Affiliations
  • 1Kwangju Christian Hospital, Korea. nsmh1@hanmail.net

Abstract


OBJECTIVE
The incidence rate of stroke as a result of intracranial arterial stenosis (ICAS) is higher in Asian countries than in the West. We aimed to analyze the regression, lack of change, or progression of asymptomatic ICAS after the administration of rosuvastatin and associated factors.
METHODS
The patients who had undergone computed tomography angiography (CTA) at our hospital and had been diagnosed with ICAS with no ischemic event in the stenosed vascular territory were included in the study. They were administered 20mg of rosuvastatin per day. After a follow-up period of at least 6 months after treatment, the patients were examined using CTA again and the clinical information and imaging results were analyzed.
RESULTS
In total, 48 patients were diagnosed with asymptomatic ICAS. During the final follow-up examination, it was found that the stenotic lesion regressed in 30 patients, whereas it remained unchanged or progressed without any adverse effects in 18 patients. In univariate analysis, the regressed group showed significantly higher differences in the levels of total cholesterol and low-density lipoprotein (LDL) between their initial and final values (both, p=0.031 for both). In the multivariate analysis, a significantly higher difference in the levels of LDL between its initial and final measurement was seen in the regressed group (p=0.035, odds ratio(OR) 3.9).
CONCLUSIONS
Rosuvastatin was found to have better lipid-lowering effects for total cholesterol and particularly LDL in patients whose ICAS had regressed. We concluded that rosuvastatin administration can be recommended for the treatment of patients with asymptomatic ICAS.

Keyword

intracranial arterial stenosis; stroke; atherosclerosis; statin

MeSH Terms

Angiography
Asian Continental Ancestry Group
Atherosclerosis
Cholesterol
Constriction, Pathologic*
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Incidence
Lipoproteins
Multivariate Analysis
Rosuvastatin Calcium
Stroke
Cholesterol
Lipoproteins
Rosuvastatin Calcium
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