In this exciting single-center pilot trial, researchers investigated whether a high dose of atorvastatin could prevent ischemic brain damage after carotid artery stenting (CAS). The study included 130 patients who were randomly assigned to receive either a high dose (80 mg/day) or a standard dose (20 mg/day) of atorvastatin before and after CAS. The primary endpoint was the cumulative incidence of silent new ischemic cerebral lesions (sNICL), transient ischemic attack (TIA), or ischemic stroke within 30 days after CAS. While the overall incidence of major endpoint events did not significantly differ between the high-dose and standard-dose groups, stratified analysis revealed that the incidence of sNICL was significantly lower in the high-dose group among symptomatic patients. These findings suggest that high-dose statins may be effective in reducing sNICL after CAS in patients with symptomatic carotid stenosis. However, further research is needed to determine the optimal dose and course of perioperative statin therapy in CAS patients. To dive deeper into the study, check out the full article on Clinicaltrials.gov.
ObjectiveCarotid artery stenting (CAS) performed perioperatively with high-dose atorvastatin may reduce the incidence of new ischemic brain lesions, but more high-level evidence is needed. Furthermore, the optimal dose and course of perioperative statin therapy remain uncertain.MethodsA single-center, prospective, parallel controlled, pilot randomized clinical trial was conducted at Beijing Hospital. The study includes a total of 130 patients with CAS. The patients were randomly assigned to receive a high-dose of 80 mg/day atorvastatin (n = 65) or a standard-dose of 20 mg/day atorvastatin (n = 65) 3 days before and 3 days after planned CAS. The primary endpoint event was the cumulative incidence of silent new ischemic cerebral lesions (sNICL) on post-CAS cerebral diffusion-weighted magnetic resonance imaging (DW-MRI), transient ischemic attack (TIA), or ischemic stroke within 30 days after CAS.ResultsAmong the 130 patients, 123 completed the study, of which 63 were in the high-dose group and 60 were in the standard-dose group. The incidence of major endpoint events was 69.8% (44 cases) and 78.3% (46 cases) in the high-dose and standard-dose groups, respectively. There was no significant difference between the two groups (HR, 0.705; 95% CI, 0.315–1.576; p = 0.393). According to the stratified analysis results, the sNICL incidence was significantly different between the two groups in the symptomatic patients (HR, 0.263; 95% CI, 0.70–0.984; p = 0.04).ConclusionAmong patients with CAS, a periprocedural high-dose of atorvastatin did not reduce the rate of periprocedural ischemic brain damage. However, high-dose statins can reduce the incidence of sNICL after CAS in patients with symptomatic carotid stenosis.Clinical Trial RegistrationClinicaltrials.gov, identifier NCT03079115.
Dr. David Lowemann, M.Sc, Ph.D., is a co-founder of the Institute for the Future of Human Potential, where he leads the charge in pioneering Self-Enhancement Science for the Success of Society. With a keen interest in exploring the untapped potential of the human mind, Dr. Lowemann has dedicated his career to pushing the boundaries of human capabilities and understanding.
Armed with a Master of Science degree and a Ph.D. in his field, Dr. Lowemann has consistently been at the forefront of research and innovation, delving into ways to optimize human performance, cognition, and overall well-being. His work at the Institute revolves around a profound commitment to harnessing cutting-edge science and technology to help individuals lead more fulfilling and intelligent lives.
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