Combination treatment of atorvastatin and fasudil ameliorate cerebral vasospasm after subarachnoid hemorrhage [Subaraknoid kanama Sonrası Serebral Vazospazmı atorvastatin ve fasudil kombine tedavisi düzeltir]

Objective: cerebral vasospasm (cv) and early brain injury remain major causes of morbidity and mortality after aneurysmal subarachnoid hemorrhage (sah). the aims of this study were to investigate whether combination treatment,with atorvastatin as an inhibitor of rhoa and fasudil as an inhibitor of rho-kinase,prevents the cv. methods: atovastatin,fasudil,or combination treatment were administrated. ischemic lesion size was measured using computed tomography on the last available scan. angiographic narrowing was semiquantitatively assessed in patients with vasospasm. the primary end point was the occurrence of cerebral infarction or symptomatic vasospasm (sv) caused by cv. the secondary end point was clinical outcome 6 months later. results: in the trial population,cerebral infarction（20.5% vs.27.5% vs.29.3%） and sv（20.5% vs.26.8% vs. 27.5%） were significantly lower in the combination treatment group than in fasudil and atovastatin groups (both p<0.05). no differences were found between statin,fasudil,and combination groups regarding rescue therapy intensity (p>0.05),mrs (p=0.06),and gos (p>0.05) at 6 months. in the overall population,patients with sv had poorer clinical outcomes (p=0.05). conclusion: combination treatment reduces the incidence,severity and the ischemic consequences of vasospasm. although no improvement of clinical outcome was seen in the combination population,there was a tendency for a better clinical outcome. © 2015,ege university press. all rights reserved.