Statins and Intracerebral Hemorrhage Collaborative Systematic Review and Meta-Analysis
Identifieur interne : 006707 ( Main/Exploration ); précédent : 006706; suivant : 006708Statins and Intracerebral Hemorrhage Collaborative Systematic Review and Meta-Analysis
Auteurs : Daniel G. Hackam [Canada] ; Mark Woodward [Australie] ; L. Kristin Newby [États-Unis] ; Deepak L. Bhatt [États-Unis] ; Mingyuan Shao [États-Unis] ; Eric E. Smith [Canada] ; Allan Donner [Canada] ; Muhammad Mamdani [Canada] ; James D. Douketis [Canada] ; Hisatomi Arima [Australie] ; John Chalmers [Australie] ; Stephen Macmahon [Australie] ; David L. Tirschwell [États-Unis] ; Bruce M. Psaty [États-Unis] ; Cheryl D. Bushnell [États-Unis] ; Maria I. Aguilar [États-Unis] ; Dan J. Capampangan [États-Unis] ; David J. Werring [Royaume-Uni] ; Paola De Rango [Italie] ; Anand Viswanathan [États-Unis] ; Nicolas Danchin [France] ; Ching-Lan Cheng [Taïwan] ; Yea-Huei Kao Yang [Taïwan] ; B. Marianne Verdel [Pays-Bas] ; Mei-Shu Lai [Taïwan] ; James Kennedy [Royaume-Uni] ; Shinichiro Uchiyama [Japon] ; Takenori Yamaguchi [Japon] ; Yasuo Ikeda [Japon] ; Marko Mrkobrada [Canada]Source :
- Circulation : (New York, N.Y.) [ 0009-7322 ] ; 2011.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Background-A recent large, randomized trial suggested that statins may increase the risk of intracerebral hemorrhage. Accordingly, we systematically reviewed the association of statins with intracerebral hemorrhage in randomized and observational data. Methods and Results-We screened 17 electronic bibliographic databases to identify eligible studies and consulted with experts in the field. We used DerSimonian-Laird random-effects models to compute summary risk ratios with 95% confidence intervals. Randomized trials, cohort studies, and case-control studies were analyzed separately. Only adjusted risk estimates were used for pooling observational data. We included published and unpublished data from 23 randomized trials and 19 observational studies. The complete data set comprised 248 391 patients and 14 784 intracerebral hemorrhages. Statins were not associated with an increased risk of intracerebral hemorrhage in randomized trials (risk ratio, 1.10; 95% confidence interval, 0.86-1.41), cohort studies (risk ratio, 0.94; 95% confidence interval, 0.81-1.10), or case-control studies (risk ratio, 0.60; 95% confidence interval, 0.41-0.88). Substantial statistical heterogeneity was evident for the case-control studies (I2=66%, P=0.01), but not for the cohort studies (I2=0%, P=0.48) or randomized trials (I2=30%, P=0.09). Sensitivity analyses by study design features, patient characteristics, or magnitude of cholesterol lowering did not materially alter the results. Conclusions-We found no evidence that statins were associated with intracerebral hemorrhage; if such a risk is present, its absolute magnitude is likely to be small and outweighed by the other cardiovascular benefits of these drugs.
Affiliations:
- Australie, Canada, France, Italie, Japon, Pays-Bas, Royaume-Uni, Taïwan, États-Unis
- Alberta, Angleterre, Grand Londres, Massachusetts, Nouvelle-Galles du Sud, Ontario, Oxfordshire, Région de Kantō, Utrecht (province), Washington (État), Île-de-France
- Boston, Calgary, Hamilton (Ontario), Londres, Oxford, Paris, Seattle, Sydney, Tokyo, Toronto, Utrecht
- Université McMaster, Université Paris-Descartes, Université d'Oxford, Université d'Utrecht, Université de Calgary, Université de Sydney, Université de Toronto, Université de Washington
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Le document en format XML
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Hackam</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>University of Western Ontario</s1><s2>London, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of Western Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>George Institute for Global Health, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Kristin Newby, L" sort="Kristin Newby, L" uniqKey="Kristin Newby L" first="L." last="Kristin Newby">L. 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Tirschwell</name><affiliation wicri:level="4"><inist:fA14 i1="09"><s1>University of Washington</s1><s2>Seattle</s2><s3>USA</s3><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Seattle</settlement><region type="state">Washington (État)</region></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Psaty, Bruce M" sort="Psaty, Bruce M" uniqKey="Psaty B" first="Bruce M." last="Psaty">Bruce M. Psaty</name><affiliation wicri:level="4"><inist:fA14 i1="09"><s1>University of Washington</s1><s2>Seattle</s2><s3>USA</s3><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Seattle</settlement><region type="state">Washington (État)</region></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Bushnell, Cheryl D" sort="Bushnell, Cheryl D" uniqKey="Bushnell C" first="Cheryl D." last="Bushnell">Cheryl D. Bushnell</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Wake Forest Baptist Medical Center</s1><s2>Winston-Salem, NC</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Wake Forest Baptist Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Aguilar, Maria I" sort="Aguilar, Maria I" uniqKey="Aguilar M" first="Maria I." last="Aguilar">Maria I. Aguilar</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Mayo Clinic</s1><s2>Scottsdale, AZ</s2><s3>USA</s3><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Mayo Clinic</wicri:noRegion></affiliation></author><author><name sortKey="Capampangan, Dan J" sort="Capampangan, Dan J" uniqKey="Capampangan D" first="Dan J." last="Capampangan">Dan J. Capampangan</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Mayo Clinic</s1><s2>Scottsdale, AZ</s2><s3>USA</s3><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Mayo Clinic</wicri:noRegion></affiliation></author><author><name sortKey="Werring, David J" sort="Werring, David J" uniqKey="Werring D" first="David J." last="Werring">David J. Werring</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>UCL Institute of Neurology</s1><s2>London</s2><s3>GBR</s3><sZ>18 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="De Rango, Paola" sort="De Rango, Paola" uniqKey="De Rango P" first="Paola" last="De Rango">Paola De Rango</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Hospital S.M. Misericordia, University of Perugia</s1><s2>Perugia</s2><s3>ITA</s3><sZ>19 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Perugia</wicri:noRegion></affiliation></author><author><name sortKey="Viswanathan, Anand" sort="Viswanathan, Anand" uniqKey="Viswanathan A" first="Anand" last="Viswanathan">Anand Viswanathan</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Massachusetts General Hospital Stroke Research Center and Harvard Medical School</s1><s2>Boston</s2><s3>USA</s3><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Danchin, Nicolas" sort="Danchin, Nicolas" uniqKey="Danchin N" first="Nicolas" last="Danchin">Nicolas Danchin</name><affiliation wicri:level="4"><inist:fA14 i1="15"><s1>Hôpital Européen Georges-Pompidou, AP-HP, Université Paris-Descartes</s1><s2>Paris</s2><s3>FRA</s3><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Cheng, Ching Lan" sort="Cheng, Ching Lan" uniqKey="Cheng C" first="Ching-Lan" last="Cheng">Ching-Lan Cheng</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>National Cheng Kung University</s1><s2>Tainan</s2><s3>TWN</s3><sZ>22 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>National Cheng Kung University</wicri:noRegion></affiliation></author><author><name sortKey="Kao Yang, Yea Huei" sort="Kao Yang, Yea Huei" uniqKey="Kao Yang Y" first="Yea-Huei" last="Kao Yang">Yea-Huei Kao Yang</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>National Cheng Kung University</s1><s2>Tainan</s2><s3>TWN</s3><sZ>22 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>National Cheng Kung University</wicri:noRegion></affiliation></author><author><name sortKey="Marianne Verdel, B" sort="Marianne Verdel, B" uniqKey="Marianne Verdel B" first="B." last="Marianne Verdel">B. Marianne Verdel</name><affiliation wicri:level="4"><inist:fA14 i1="17"><s1>Utrecht University</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>24 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region><settlement type="city">Utrecht</settlement></placeName><orgName type="university">Université d'Utrecht</orgName></affiliation></author><author><name sortKey="Lai, Mei Shu" sort="Lai, Mei Shu" uniqKey="Lai M" first="Mei-Shu" last="Lai">Mei-Shu Lai</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>National Taiwan University</s1><s2>Taipei</s2><s3>TWN</s3><sZ>25 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>National Taiwan University</wicri:noRegion></affiliation></author><author><name sortKey="Kennedy, James" sort="Kennedy, James" uniqKey="Kennedy J" first="James" last="Kennedy">James Kennedy</name><affiliation wicri:level="4"><inist:fA14 i1="19"><s1>John Radcliffe Hospital, University of Oxford</s1><s2>Oxfordshire</s2><s3>GBR</s3><sZ>26 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Uchiyama, Shinichiro" sort="Uchiyama, Shinichiro" uniqKey="Uchiyama S" first="Shinichiro" last="Uchiyama">Shinichiro Uchiyama</name><affiliation wicri:level="3"><inist:fA14 i1="20"><s1>Tokyo Women's Medical University</s1><s2>Tokyo</s2><s3>JPN</s3><sZ>27 aut.</sZ></inist:fA14><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Yamaguchi, Takenori" sort="Yamaguchi, Takenori" uniqKey="Yamaguchi T" first="Takenori" last="Yamaguchi">Takenori Yamaguchi</name><affiliation wicri:level="1"><inist:fA14 i1="21"><s1>National Cardiovascular Center</s1><s2>Suita</s2><s3>JPN</s3><sZ>28 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>National Cardiovascular Center</wicri:noRegion></affiliation></author><author><name sortKey="Ikeda, Yasuo" sort="Ikeda, Yasuo" uniqKey="Ikeda Y" first="Yasuo" last="Ikeda">Yasuo Ikeda</name><affiliation wicri:level="3"><inist:fA14 i1="22"><s1>Waseda University</s1><s2>Tokyo</s2><s3>JPN</s3><sZ>29 aut.</sZ></inist:fA14><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Mrkobrada, Marko" sort="Mrkobrada, Marko" uniqKey="Mrkobrada M" first="Marko" last="Mrkobrada">Marko Mrkobrada</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>University of Western Ontario</s1><s2>London, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of Western Ontario</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0016071</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 12-0016071 INIST</idno><idno type="RBID">Pascal:12-0016071</idno><idno type="wicri:Area/PascalFrancis/Corpus">001740</idno><idno type="wicri:Area/PascalFrancis/Curation">004769</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001660</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">001660</idno><idno type="wicri:doubleKey">0009-7322:2011:Hackam D:statins:and:intracerebral</idno><idno type="wicri:Area/Main/Merge">006B11</idno><idno type="wicri:Area/Main/Curation">006707</idno><idno type="wicri:Area/Main/Exploration">006707</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Statins and Intracerebral Hemorrhage Collaborative Systematic Review and Meta-Analysis</title><author><name sortKey="Hackam, Daniel G" sort="Hackam, Daniel G" uniqKey="Hackam D" first="Daniel G." last="Hackam">Daniel G. Hackam</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>University of Western Ontario</s1><s2>London, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of Western Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>George Institute for Global Health, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Kristin Newby, L" sort="Kristin Newby, L" uniqKey="Kristin Newby L" first="L." last="Kristin Newby">L. Kristin Newby</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Duke Clinical Research Institute, Duke University Medical Center</s1><s2>Durham, NC</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Durham, NC</wicri:noRegion></affiliation></author><author><name sortKey="Bhatt, Deepak L" sort="Bhatt, Deepak L" uniqKey="Bhatt D" first="Deepak L." last="Bhatt">Deepak L. Bhatt</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>VA Boston Healthcare System, Brigham and Women's Hospital, and Harvard Medical, School</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Shao, Mingyuan" sort="Shao, Mingyuan" uniqKey="Shao M" first="Mingyuan" last="Shao">Mingyuan Shao</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Cleveland Clinic</s1><s2>Cleveland, OH</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cleveland Clinic</wicri:noRegion></affiliation></author><author><name sortKey="Smith, Eric E" sort="Smith, Eric E" uniqKey="Smith E" first="Eric E." last="Smith">Eric E. Smith</name><affiliation wicri:level="4"><inist:fA14 i1="06"><s1>Hotchkiss Brain Institute, University of Calgary</s1><s2>Calgary, AB</s2><s3>CAN</s3><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName><orgName type="university">Université de Calgary</orgName></affiliation></author><author><name sortKey="Donner, Allan" sort="Donner, Allan" uniqKey="Donner A" first="Allan" last="Donner">Allan Donner</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>University of Western Ontario</s1><s2>London, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of Western Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Mamdani, Muhammad" sort="Mamdani, Muhammad" uniqKey="Mamdani M" first="Muhammad" last="Mamdani">Muhammad Mamdani</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Applied Health Research Centre, University of Toronto</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>8 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Douketis, James D" sort="Douketis, James D" uniqKey="Douketis J" first="James D." last="Douketis">James D. Douketis</name><affiliation wicri:level="4"><inist:fA14 i1="08"><s1>McMaster University</s1><s2>Hamilton, ON</s2><s3>CAN</s3><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université McMaster</orgName></affiliation></author><author><name sortKey="Arima, Hisatomi" sort="Arima, Hisatomi" uniqKey="Arima H" first="Hisatomi" last="Arima">Hisatomi Arima</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>George Institute for Global Health, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>George Institute for Global Health, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Macmahon, Stephen" sort="Macmahon, Stephen" uniqKey="Macmahon S" first="Stephen" last="Macmahon">Stephen Macmahon</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>George Institute for Global Health, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Tirschwell, David L" sort="Tirschwell, David L" uniqKey="Tirschwell D" first="David L." last="Tirschwell">David L. Tirschwell</name><affiliation wicri:level="4"><inist:fA14 i1="09"><s1>University of Washington</s1><s2>Seattle</s2><s3>USA</s3><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Seattle</settlement><region type="state">Washington (État)</region></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Psaty, Bruce M" sort="Psaty, Bruce M" uniqKey="Psaty B" first="Bruce M." last="Psaty">Bruce M. Psaty</name><affiliation wicri:level="4"><inist:fA14 i1="09"><s1>University of Washington</s1><s2>Seattle</s2><s3>USA</s3><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Seattle</settlement><region type="state">Washington (État)</region></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Bushnell, Cheryl D" sort="Bushnell, Cheryl D" uniqKey="Bushnell C" first="Cheryl D." last="Bushnell">Cheryl D. Bushnell</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Wake Forest Baptist Medical Center</s1><s2>Winston-Salem, NC</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Wake Forest Baptist Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Aguilar, Maria I" sort="Aguilar, Maria I" uniqKey="Aguilar M" first="Maria I." last="Aguilar">Maria I. Aguilar</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Mayo Clinic</s1><s2>Scottsdale, AZ</s2><s3>USA</s3><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Mayo Clinic</wicri:noRegion></affiliation></author><author><name sortKey="Capampangan, Dan J" sort="Capampangan, Dan J" uniqKey="Capampangan D" first="Dan J." last="Capampangan">Dan J. Capampangan</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Mayo Clinic</s1><s2>Scottsdale, AZ</s2><s3>USA</s3><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Mayo Clinic</wicri:noRegion></affiliation></author><author><name sortKey="Werring, David J" sort="Werring, David J" uniqKey="Werring D" first="David J." last="Werring">David J. Werring</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>UCL Institute of Neurology</s1><s2>London</s2><s3>GBR</s3><sZ>18 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="De Rango, Paola" sort="De Rango, Paola" uniqKey="De Rango P" first="Paola" last="De Rango">Paola De Rango</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Hospital S.M. Misericordia, University of Perugia</s1><s2>Perugia</s2><s3>ITA</s3><sZ>19 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Perugia</wicri:noRegion></affiliation></author><author><name sortKey="Viswanathan, Anand" sort="Viswanathan, Anand" uniqKey="Viswanathan A" first="Anand" last="Viswanathan">Anand Viswanathan</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Massachusetts General Hospital Stroke Research Center and Harvard Medical School</s1><s2>Boston</s2><s3>USA</s3><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Danchin, Nicolas" sort="Danchin, Nicolas" uniqKey="Danchin N" first="Nicolas" last="Danchin">Nicolas Danchin</name><affiliation wicri:level="4"><inist:fA14 i1="15"><s1>Hôpital Européen Georges-Pompidou, AP-HP, Université Paris-Descartes</s1><s2>Paris</s2><s3>FRA</s3><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Cheng, Ching Lan" sort="Cheng, Ching Lan" uniqKey="Cheng C" first="Ching-Lan" last="Cheng">Ching-Lan Cheng</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>National Cheng Kung University</s1><s2>Tainan</s2><s3>TWN</s3><sZ>22 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>National Cheng Kung University</wicri:noRegion></affiliation></author><author><name sortKey="Kao Yang, Yea Huei" sort="Kao Yang, Yea Huei" uniqKey="Kao Yang Y" first="Yea-Huei" last="Kao Yang">Yea-Huei Kao Yang</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>National Cheng Kung University</s1><s2>Tainan</s2><s3>TWN</s3><sZ>22 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>National Cheng Kung University</wicri:noRegion></affiliation></author><author><name sortKey="Marianne Verdel, B" sort="Marianne Verdel, B" uniqKey="Marianne Verdel B" first="B." last="Marianne Verdel">B. Marianne Verdel</name><affiliation wicri:level="4"><inist:fA14 i1="17"><s1>Utrecht University</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>24 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region><settlement type="city">Utrecht</settlement></placeName><orgName type="university">Université d'Utrecht</orgName></affiliation></author><author><name sortKey="Lai, Mei Shu" sort="Lai, Mei Shu" uniqKey="Lai M" first="Mei-Shu" last="Lai">Mei-Shu Lai</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>National Taiwan University</s1><s2>Taipei</s2><s3>TWN</s3><sZ>25 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>National Taiwan University</wicri:noRegion></affiliation></author><author><name sortKey="Kennedy, James" sort="Kennedy, James" uniqKey="Kennedy J" first="James" last="Kennedy">James Kennedy</name><affiliation wicri:level="4"><inist:fA14 i1="19"><s1>John Radcliffe Hospital, University of Oxford</s1><s2>Oxfordshire</s2><s3>GBR</s3><sZ>26 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Uchiyama, Shinichiro" sort="Uchiyama, Shinichiro" uniqKey="Uchiyama S" first="Shinichiro" last="Uchiyama">Shinichiro Uchiyama</name><affiliation wicri:level="3"><inist:fA14 i1="20"><s1>Tokyo Women's Medical University</s1><s2>Tokyo</s2><s3>JPN</s3><sZ>27 aut.</sZ></inist:fA14><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Yamaguchi, Takenori" sort="Yamaguchi, Takenori" uniqKey="Yamaguchi T" first="Takenori" last="Yamaguchi">Takenori Yamaguchi</name><affiliation wicri:level="1"><inist:fA14 i1="21"><s1>National Cardiovascular Center</s1><s2>Suita</s2><s3>JPN</s3><sZ>28 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>National Cardiovascular Center</wicri:noRegion></affiliation></author><author><name sortKey="Ikeda, Yasuo" sort="Ikeda, Yasuo" uniqKey="Ikeda Y" first="Yasuo" last="Ikeda">Yasuo Ikeda</name><affiliation wicri:level="3"><inist:fA14 i1="22"><s1>Waseda University</s1><s2>Tokyo</s2><s3>JPN</s3><sZ>29 aut.</sZ></inist:fA14><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Mrkobrada, Marko" sort="Mrkobrada, Marko" uniqKey="Mrkobrada M" first="Marko" last="Mrkobrada">Marko Mrkobrada</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>University of Western Ontario</s1><s2>London, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of Western Ontario</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Circulation : (New York, N.Y.)</title><title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title><idno type="ISSN">0009-7322</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Circulation : (New York, N.Y.)</title><title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title><idno type="ISSN">0009-7322</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antilipemic agent</term><term>Cardiovascular disease</term><term>Cerebral hemorrhage</term><term>Cerebrovascular disease</term><term>Statin derivative</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Hémorragie cérébrale</term><term>Pathologie cérébrovasculaire</term><term>Pathologie de l'appareil circulatoire</term><term>Dérivé de la statine</term><term>Hypolipémiant</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background-A recent large, randomized trial suggested that statins may increase the risk of intracerebral hemorrhage. Accordingly, we systematically reviewed the association of statins with intracerebral hemorrhage in randomized and observational data. Methods and Results-We screened 17 electronic bibliographic databases to identify eligible studies and consulted with experts in the field. We used DerSimonian-Laird random-effects models to compute summary risk ratios with 95% confidence intervals. Randomized trials, cohort studies, and case-control studies were analyzed separately. Only adjusted risk estimates were used for pooling observational data. We included published and unpublished data from 23 randomized trials and 19 observational studies. The complete data set comprised 248 391 patients and 14 784 intracerebral hemorrhages. Statins were not associated with an increased risk of intracerebral hemorrhage in randomized trials (risk ratio, 1.10; 95% confidence interval, 0.86-1.41), cohort studies (risk ratio, 0.94; 95% confidence interval, 0.81-1.10), or case-control studies (risk ratio, 0.60; 95% confidence interval, 0.41-0.88). Substantial statistical heterogeneity was evident for the case-control studies (I<sup>2</sup>=66%, P=0.01), but not for the cohort studies (I<sup>2</sup>=0%, P=0.48) or randomized trials (I<sup>2</sup>=30%, P=0.09). Sensitivity analyses by study design features, patient characteristics, or magnitude of cholesterol lowering did not materially alter the results. Conclusions-We found no evidence that statins were associated with intracerebral hemorrhage; if such a risk is present, its absolute magnitude is likely to be small and outweighed by the other cardiovascular benefits of these drugs.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Canada</li><li>France</li><li>Italie</li><li>Japon</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Taïwan</li><li>États-Unis</li></country><region><li>Alberta</li><li>Angleterre</li><li>Grand Londres</li><li>Massachusetts</li><li>Nouvelle-Galles du Sud</li><li>Ontario</li><li>Oxfordshire</li><li>Région de Kantō</li><li>Utrecht (province)</li><li>Washington (État)</li><li>Île-de-France</li></region><settlement><li>Boston</li><li>Calgary</li><li>Hamilton (Ontario)</li><li>Londres</li><li>Oxford</li><li>Paris</li><li>Seattle</li><li>Sydney</li><li>Tokyo</li><li>Toronto</li><li>Utrecht</li></settlement><orgName><li>Université McMaster</li><li>Université Paris-Descartes</li><li>Université d'Oxford</li><li>Université d'Utrecht</li><li>Université de Calgary</li><li>Université de Sydney</li><li>Université de Toronto</li><li>Université de Washington</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Hackam, Daniel G" sort="Hackam, Daniel G" uniqKey="Hackam D" first="Daniel G." last="Hackam">Daniel G. Hackam</name></noRegion><name sortKey="Donner, Allan" sort="Donner, Allan" uniqKey="Donner A" first="Allan" last="Donner">Allan Donner</name><name sortKey="Douketis, James D" sort="Douketis, James D" uniqKey="Douketis J" first="James D." last="Douketis">James D. Douketis</name><name sortKey="Mamdani, Muhammad" sort="Mamdani, Muhammad" uniqKey="Mamdani M" first="Muhammad" last="Mamdani">Muhammad Mamdani</name><name sortKey="Mrkobrada, Marko" sort="Mrkobrada, Marko" uniqKey="Mrkobrada M" first="Marko" last="Mrkobrada">Marko Mrkobrada</name><name sortKey="Smith, Eric E" sort="Smith, Eric E" uniqKey="Smith E" first="Eric E." last="Smith">Eric E. Smith</name></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name></region><name sortKey="Arima, Hisatomi" sort="Arima, Hisatomi" uniqKey="Arima H" first="Hisatomi" last="Arima">Hisatomi Arima</name><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name><name sortKey="Macmahon, Stephen" sort="Macmahon, Stephen" uniqKey="Macmahon S" first="Stephen" last="Macmahon">Stephen Macmahon</name></country><country name="États-Unis"><noRegion><name sortKey="Kristin Newby, L" sort="Kristin Newby, L" uniqKey="Kristin Newby L" first="L." last="Kristin Newby">L. Kristin Newby</name></noRegion><name sortKey="Aguilar, Maria I" sort="Aguilar, Maria I" uniqKey="Aguilar M" first="Maria I." last="Aguilar">Maria I. Aguilar</name><name sortKey="Bhatt, Deepak L" sort="Bhatt, Deepak L" uniqKey="Bhatt D" first="Deepak L." last="Bhatt">Deepak L. Bhatt</name><name sortKey="Bushnell, Cheryl D" sort="Bushnell, Cheryl D" uniqKey="Bushnell C" first="Cheryl D." last="Bushnell">Cheryl D. Bushnell</name><name sortKey="Capampangan, Dan J" sort="Capampangan, Dan J" uniqKey="Capampangan D" first="Dan J." last="Capampangan">Dan J. Capampangan</name><name sortKey="Psaty, Bruce M" sort="Psaty, Bruce M" uniqKey="Psaty B" first="Bruce M." last="Psaty">Bruce M. Psaty</name><name sortKey="Shao, Mingyuan" sort="Shao, Mingyuan" uniqKey="Shao M" first="Mingyuan" last="Shao">Mingyuan Shao</name><name sortKey="Tirschwell, David L" sort="Tirschwell, David L" uniqKey="Tirschwell D" first="David L." last="Tirschwell">David L. Tirschwell</name><name sortKey="Viswanathan, Anand" sort="Viswanathan, Anand" uniqKey="Viswanathan A" first="Anand" last="Viswanathan">Anand Viswanathan</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Werring, David J" sort="Werring, David J" uniqKey="Werring D" first="David J." last="Werring">David J. Werring</name></region><name sortKey="Kennedy, James" sort="Kennedy, James" uniqKey="Kennedy J" first="James" last="Kennedy">James Kennedy</name></country><country name="Italie"><noRegion><name sortKey="De Rango, Paola" sort="De Rango, Paola" uniqKey="De Rango P" first="Paola" last="De Rango">Paola De Rango</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Danchin, Nicolas" sort="Danchin, Nicolas" uniqKey="Danchin N" first="Nicolas" last="Danchin">Nicolas Danchin</name></region></country><country name="Taïwan"><noRegion><name sortKey="Cheng, Ching Lan" sort="Cheng, Ching Lan" uniqKey="Cheng C" first="Ching-Lan" last="Cheng">Ching-Lan Cheng</name></noRegion><name sortKey="Kao Yang, Yea Huei" sort="Kao Yang, Yea Huei" uniqKey="Kao Yang Y" first="Yea-Huei" last="Kao Yang">Yea-Huei Kao Yang</name><name sortKey="Lai, Mei Shu" sort="Lai, Mei Shu" uniqKey="Lai M" first="Mei-Shu" last="Lai">Mei-Shu Lai</name></country><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Marianne Verdel, B" sort="Marianne Verdel, B" uniqKey="Marianne Verdel B" first="B." last="Marianne Verdel">B. Marianne Verdel</name></region></country><country name="Japon"><region name="Région de Kantō"><name sortKey="Uchiyama, Shinichiro" sort="Uchiyama, Shinichiro" uniqKey="Uchiyama S" first="Shinichiro" last="Uchiyama">Shinichiro Uchiyama</name></region><name sortKey="Ikeda, Yasuo" sort="Ikeda, Yasuo" uniqKey="Ikeda Y" first="Yasuo" last="Ikeda">Yasuo Ikeda</name><name sortKey="Yamaguchi, Takenori" sort="Yamaguchi, Takenori" uniqKey="Yamaguchi T" first="Takenori" last="Yamaguchi">Takenori Yamaguchi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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