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Review

Statins in acute neurologic disease: which one,

which dose, when to start, and when not to

stop

Bong-Su Kang , Gene Sung , May Kim-Tenser , Nerses Sanossian 2,3
2,3
1
2,3
1 Department of Neurology, Korea University Anam Hospital, Seoul 136-705, South Korea.
2 Department of Neurology, University of Southern California, Los Angeles, CA 90026, USA.
3 Department of Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California, Los Angeles, CA 90026,
USA.

Dr. Bong-Su Kang finished neurology residency and fellowship of adult epilepsy at Seoul National University
Hospital in South Korea, followed by visiting fellowship in neurocritical care at University of Southern California
in USA. Dr. Kang is currently clinical assistance professor in Korea University Anam Hospital since 2014.

A B S T R AC T
Statins could have physiologic properties that may benefit patients that have been diagnosed with various acute neurological diseases.
This review aims tosummarize the literature pertaining to stain use in acute neurological disease such as subarachnoid hemorrhage,
intracerebral hemorrhage (ICH), cerebral ischemia (CI), traumatic brain injury, status epilepticus and meningitis. The authors reviewed
published abstracts and manuscripts pertaining to experimental and clinical trials relevant to statins in acute neurological disease. Although
acute statin therapy in the setting of subarachnoid hemorrhage might reduce delayed cerebral ischemia and mortality, it should not be
considered standard care at this time. Acute statins therapy has not demonstrated anybenefit yet following an ICH or CI. Acute statin
withdrawal may worsen outcome in acute CI. Observational and case-control studies suggest that pretreatment with statin at time of onset
may be associated with better outcomes. Even though preclinical studies have shown statins to have beneficial effects, there has been
no clinical evidence. In conclusion, current published studies have not shown that acute statin therapy has any benefical effects in acute
neurologic diseases and therefore further large randomized clinical trials are needed.
Key words: Statin; dyslipidemia; stroke prevention; subarachnoid hemorrhage; intracerebral hemorrhage; cerebral infarction

INTRODUCTION coenzyme A reductase inhibitors, are also commonly
referred to as statins. They are classified as a
[1]
therapeutic class of lipid lowering agents and are
The drug class of potent inhibitors of cholesterol
established in the primary and secondary prevention
biosynthesis called the 3-hydroxy-methyglutaryl of vascular diseases. Recent experimental and clinical
evidence suggests that statins have cholesterol
Corresponding Author: Dr. Gene Sung, Department of
Neurology, LAC+USC Medical Center, 1100 North State Street,
Los Angeles, CA 90026, USA. Email: gsung@usc.edu This is an open access article distributed under the terms of the Creative
Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows
others to remix, tweak, and build upon the work non-commercially, as long as the
Access this article online author is credited and the new creations are licensed under the identical terms.
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Website: For reprints contact: service@oaepublish.com
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Cite this article as: Kang BS, Sung G, Kim-Tenser M, Sanossian N.
Statins in acute neurologic disease: which one, which dose, when to start,
DOI: 10.20517/2347-8659.2015.27 and when not to stop. Neuroimmunol Neuroinflammation 2016;3:133-40.
Received: 16-06-2015; Accepted: 25-12-2015.

© 2016 Neuroimmunology and Neuroinflammation | Published by OAE Publishing Inc. 133