Effect of statins treatment for patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis of observational studies and randomized controlled trials.

Vasospasm is one of the most common complications after aneurysmal subarachnoid hemorrhage.Statins have been proven to be effective to reduce the incidence of vasospasm both in experimental subarachnoid hemorrhage and several clinical trials before. This meta-analysis aimed to investigate the efficacy of statins for patients with aneurysmal subarachnoid hemorrhage. We made strict search strategies to select the randomized controlled trial and observational studies published up to December 20(th) 2014. Outcomes of interest were cerebral vasospasm, delayed cerebral ischemia and poor outcome. Data analyses of RCTs and observational studies were made separately. Finally six randomized clinical trial and eight observational studies were included in this meta-analysis. There were in total 1031 patients in six RCTs with 504 patients received statins and 527 patients in placebo group. 561 patients with statins compared with 1579 patients in no statin-use group were finally included in 8 observational studies. Outcomes included in this meta-analysis (cerebral vasospasm, DIC and poor outcome) all indicated no statistical significance between two groups both in RCTs and observational studies. No benefits of statins-use for patients with aneurysmal subarachnoid hemorrhage were observed in both RCTs and observational studies, which was quite different from the results of several previous meta-analysis.