Beta-blocker therapy and impact on outcome after aneurysmal subarachnoid hemorrhage: a cohort study

Journal of Neurosurgery
Nohra ChalouhiFred Rincon

Abstract

OBJECTIVE Cerebral vasospasm (cVSP) is a frequent complication of aneurysmal subarachnoid hemorrhage (aSAH), with a significant impact on outcome. Beta blockers (BBs) may blunt the sympathetic effect and catecholamine surge associated with ruptured cerebral aneurysms and prevent cardiac dysfunction. The purpose of this study was to investigate the association between preadmission BB therapy and cVSP, cardiac dysfunction, and in-hospital mortality following aSAH. METHODS This was a retrospective cohort study of patients with aSAH who were treated at a tertiary high-volume neurovascular referral center. The exposure was defined as any preadmission BB therapy. The primary outcome was cVSP assessed by serial transcranial Doppler with any mean flow velocity ≥ 120 cm/sec and/or need for endovascular intervention for medically refractory cVSP. Secondary outcomes were cardiac dysfunction (defined as cardiac troponin-I elevation > 0.05 μg/L, low left ventricular ejection fraction [LVEF] < 40%, or LV wall motion abnormalities [LVWMA]) and in-hospital mortality. RESULTS The cohort consisted of 210 patients treated between February 2009 and September 2010 (55% were women), with a mean age of 53.4 ± 13 years and median Hunt and Hess Grade I...Continue Reading

References

Feb 11, 1992·Stroke; a Journal of Cerebral Circulation·E C HaleyJ C Torner
Jan 1, 1970·Brain : a Journal of Neurology·E Nelson, M Rennels
Jun 26, 2003·Neurosurgery·Aaron S DumontKevin S Lee
Feb 24, 2010·Critical Care : the Official Journal of the Critical Care Forum·Jan W DankbaarIrene C van der Schaaf
Nov 23, 2011·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Conrad W LiangNeeraj Naval
Dec 24, 2013·Neurology·Ivo van der BiltUNKNOWN SEASAH (Serial Echocardiography After Subarachnoid Hemorrhage) Investigators

❮ Previous
Next ❯

Citations

Jan 21, 2017·Journal of Neurosurgery·Ambuj KumarBhawani S Sharma
Sep 5, 2017·Acta Neurologica Scandinavica·M SykoraD Strbian
Apr 10, 2019·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Aisha R SaandSherry H-Y Chou
Jan 30, 2020·Neurocritical Care·Aravind V RameshMatt Thomas
Dec 29, 2020·Neurosurgery·Christopher M JacksonMichael Lim

❮ Previous
Next ❯

Software Mentioned

Stata

Related Concepts

Related Feeds

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

Related Papers

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
O O ZaidatC Graffagnino
Neurology
Ivo van der BiltSEASAH (Serial Echocardiography After Subarachnoid Hemorrhage) Investigators
© 2022 Meta ULC. All rights reserved