The effect of intensive statin therapy in non-symptomatic intracranial arteries: The STAMINA-MRI sub-study

Jae Eun Sim; Ha-Na Song; Jong-Un Choi; Ji-Eun Lee; In Young Baek; Hwan-Ho Cho; Jong-Hoon Kim; Jong-Won Chung; Gyeong-Moon Kim; Hyun-Jin Park; Oh Young Bang; Woo-Keun Seo

doi:10.3389/fneur.2023.1069502

The effect of intensive statin therapy in non-symptomatic intracranial arteries: The STAMINA-MRI sub-study

Front Neurol. 2023 Mar 28:14:1069502. doi: 10.3389/fneur.2023.1069502. eCollection 2023.

Authors

Affiliations

¹ Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
² Department of Electronic Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Republic of Korea.
³ School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, Republic of Korea.
⁴ Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea.

Abstract

Background and aims: Pleiotropic effects of statins result in the stabilization of symptomatic intracranial arterial plaque. However, little is known about the effect of statins in non-symptomatic cerebral arteries. We hypothesized that intensive statin therapy could produce a change in the non-symptomatic cerebral arteries.

Methods: This is a sub-study of a prospective observational study under the title of "Intensive Statin Treatment in Acute Ischemic Stroke Patients with Intracranial Atherosclerosis: a High-Resolution Magnetic Resonance Imaging (HR-MRI) study." Patients with statin-naive acute ischemic stroke who had symptomatic intracranial artery stenosis (above 50%) were recruited for this study. HR-MRI was performed to assess the patients' cerebral arterial status before and 6 months after the statin therapy. To demonstrate the effect of statins in the non-symptomatic segment of intracranial cerebral arteries, we excluded symptomatic segments from the data to be analyzed. We compared the morphological changes using cerebrovascular morphometry.

Results: A total of 54 patients (mean age: 62.9 ± 14.4 years, 59.3% women) were included in this study. Intensive statin therapy produced significant morphological changes of overall cerebral arteries. Among the morphological features, the arterial luminal area showed the highest number of significant changes with a range from 5.7 and 6.7%. Systolic blood pressure (SBP) was an independent factor associated with relative changes in posterior circulation bed maximal diameter percentage change (beta -0.21, 95% confidence interval -0.36 to -0.07, p = 0.005).

Conclusion: Intensive statin therapy produced a favorable morphological change in cerebral arteries of not only the target arterial segment but also non-symptomatic arterial segments. The change in cerebral arterial luminal diameter was influenced by the baseline SBP and was dependent on the topographic distribution of the cerebral arteries.Clinical Trial Registration: ClinicalTrials.gov, identifier NCT02458755.

Keywords: Magnetic Resonace Imaging; artherosclerotic plaque; posterior cerebral arteries; statin (HMG-CoA reductase inhibitor); systolic pressure.

Associated data

ClinicalTrials.gov/NCT02458755