Statin use and risk of cerebral aneurysm rupture: a hospital-based case-control study in Japan

J Stroke Cerebrovasc Dis. 2014 Feb;23(2):343-8. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.022. Epub 2013 May 19.


Background: Recent reports have showed that some statins have protective effects in experimental cerebral aneurysm models. We conducted a case-control study to investigate an association between statin use and the rupture risk of cerebral aneurysm in Japanese population.

Methods: This was a multihospital case-control study; cases and controls were collected from 15 hospitals in Japan. Cases consisted of patients with aneurysmal subarachnoid hemorrhage hospitalized from April 2009 to March 2011. Controls were selected from patients who had newly diagnosed unruptured saccular aneurysms from April 2006 to March 2011. The primary exposure of interest was statin use. Multivariable logistic regression was used to assess the relationship between stain use and the rupture risk of cerebral aneurysm.

Results: A total of 117 cases and 304 controls were included in the analyses. Statin was used in 9.4% of cases and 26.0% of controls. Controls had a significantly higher rate of use of statin. The use of any statin was associated with cerebral aneurysm rupture after adjustment of potential confounders (adjusted odds ratio: .30, 95% confidence interval: .14-.66). The association was similar in each stratum of total cholesterol level.

Conclusions: This observation from a hospital-based case-control study in Japan suggested that there is inverse relationship between use of statins and cerebral aneurysm rupture. Future clinical studies are needed.

Keywords: Statin; case-control study; cerebral aneurysm; subarachnoid hemorrhage.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / etiology
  • Aneurysm, Ruptured / prevention & control*
  • Chi-Square Distribution
  • Female
  • Hospitals*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hyperlipidemias / complications
  • Hyperlipidemias / diagnosis
  • Hyperlipidemias / drug therapy*
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / diagnosis
  • Japan
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / etiology
  • Subarachnoid Hemorrhage / prevention & control*
  • Time Factors


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors