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22 Early treatment of cerebrovascular insult with atorvastatin application

Published online by Cambridge University Press:  24 June 2014

Rifat Zaid ,
Elmedin Huskic  and
Gorana Sulejmanpasic
Rifat Zaid
Affiliation:
Neurology, JU Dom Zdravlja Fojnica Medical Center, Humska 366, 71000 Sarajevo, Bosnia and Herzegovina, E-mail: [email protected]
Elmedin Huskic
Affiliation:
Neurology, JU Dom Zdravlja Fojnica Medical Center, Humska 366, 71000 Sarajevo, Bosnia and Herzegovina, E-mail: [email protected]
Gorana Sulejmanpasic
Affiliation:
Neurology, JU Dom Zdravlja Fojnica Medical Center, Humska 366, 71000 Sarajevo, Bosnia and Herzegovina, E-mail: [email protected]
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Abstract

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Type
Posters – Neurology
Information
Acta Neuropsychiatrica , Volume 21 , Issue S2: Special Issue: Abstracts of 49th Neuropsychiatric Pula Congress, 17-20 June 2009, Pula, Croatia , June 2009 , pp. 79 - 80
Copyright
Copyright © 2009 John Wiley & Sons A/S

Introduction/Objectives:

Given the above-mentioned pathophysio-logical processes that occur during the stroke, and the extreme importance of atherosclerosis behind most strokes, we felt that the early i.e. urgent treatment of stroke provided room for treatment of the very process of atherosclerosis i.e. taking advantage of additional effects of hipolypemic agent Atorvastatin (Atorvox), aimed at improvement of the total survival rate, better outcome and reduction of neurological damage in patients who suffered stroke.

Participants, Materials/Methods:

During 2-month observation of the work of the emergency service of “JU Dom Zdravlja Fojnica” medical center and its family medicine department, a group of eleven patients (seven males and four females) was covered, year of birth ranging from 1925–1950. All patients carried certain risk from development of cerebrovascular insult (Diabetes, smoking, hyperlipidemia, atrial fibrillation), and were admitted at the emergency service in 20 to 70 minutes.

Upon admittance, urgent laboratory tests (complete blood picture, blood sugar level, transaminases, CK) and ECG were made. Anti-edematous therapy was applied, norotrophic, O2 through a mask, antihypertensives (Urapidil), Atorvastatin (Atorvox) 80 mg PER OS, and the patients were urgently sent to the neurological department of the Cantonal Hospital in Travnik, where they arrived in 55 minutes average.

Results:

All 11 patients were hospitalized for 24 days in average. During hospitalization, they underwent CT, laboratory tests, and received supportive therapy without any active thrombolytic treatment (rt-PA). None of the patients had increased values of liver enzymes or creatine kinase recorded, neither during nor after hospitalization. Ten patients could function independently and perform daily activities, with minor or more serious motor problems, while one patient needed help during movement. Upon release from the hospital, all patients took routine laboratory tests, including among other things liver enzyme values and creatine kinase. All tests showed normal values, and thus there was no need to terminate the Atorvastatin(Atorvox) therapy.

Conclusions:

Analysis of recorded cases during the urgent ICV treatment, regardless of the etiology (ischemic or hemorrhagic) showed that early Atorvastatin administration, practically immediately upon insult, in a maximum one-off daily dose of 80 mg is safe from the aspect of increase in liver enzyme values. Thus, there were no cases of hepatotoxicity related to myolysis cases recorded in literature, and creatine kinase was observed. The observed group was relatively small and the observance period too short, and thus the total assumed effect, given the farmaco-logical effects, could not be fully evaluated.