Simvastatin in ischemic stroke: focus on endothelial dysfunction

Abstract

Aim.To estimate mortality and frequency of recurrent cardiovascular events, dynamics of neurological
deficit, endothelial dysfunction and renal function in patients with the first-time ischemic stroke treated with
simvastatin 40 mg/day in acute period of the disease.
Materials and methods. The efficacy of simvastatin (40 mg/day) therapy initiated in acute stage of ischemic
stroke was evaluated in 12-month comparative randomized study. Patients of the first group (n = 105)
received standard stroke therapy, and patients of the second group (n = 105) also received standard treatment
and simvastatin additionally. Combined endpoint (cardiovascular death +recurrent cardiovascular events +
necessity of readmission), dynamics of neurological status and endothelial function were considered.
Results. Primary combined endpoint was achieved in 64 cases in the first group (60,9 %) and in 49 (46,6 %)
in the second one (p = 0.037). Neurological status evaluated by National Institutes of Health Stroke Scale
(NIHSS) and Scandinavian scales had a faster positive dynamics in patients receiving simvastatin. The same
patients revealed more intense and quick decrease in desquamated plasma endotheliocytes.
Conclusion. Simvastatin 40 mg/day prescribed along with neuroprotective and antihypertensive treatment
in acute stage of ischemic stroke leads to lowering of recurrent cardiovascular events number, positive
dynamics of neurological status, regression of endothelial dysfunction , associated with improved renal
function.