Statins in the Management of Aneurysmal Subarachnoid Hemorrhage—Not (Yet) a Standard of Care

To the Editor:The use of statins after aneurysmal subarachnoid hemorrhage (SAH) has a strong scientific rationale and appears promising in preliminary clinical studies.1–2 However, the assertion by Sillberg et al that their meta-analysis “supports the routine use of statins” is too strong.3 This conclusion was based on the cumulative experience from three small single-center clinical trials involving a total of only 158 patients. The purported reduction in mortality (reported in only 2/3 trials) was based on 11 deaths among control patients compared with 2 deaths among statin-treated patients. Because of the small numbers, this finding is not particularly robust—if there had been, for example, one less death in the …