Thick and Diffuse Subarachnoid Blood as a Treatment Effect Modifier of Clazosentan After Subarachnoid Hemorrhage

Stroke; a Journal of Cerebral Circulation
Stephan A MayerRandall T Higashida

Abstract

Background and Purpose- Clazosentan, an endothelin receptor antagonist, has been shown to reduce angiographic vasospasm and vasospasm-related morbidity after aneurysmal subarachnoid hemorrhage (SAH), although no effect on long-term functional outcome has been demonstrated. Thick clot on initial computed tomography is associated with an increased risk of vasospasm and delayed cerebral ischemia. In this post hoc analysis, we hypothesized that use of clazosentan in this subpopulation would provide stronger benefit. Methods- We analyzed SAH patients enrolled in the CONSCIOUS-2 and CONSCIOUS-3 studies (Clazosentan to Overcome Neurological Ischemia and Infarction Occurring After Subarachnoid Hemorrhage) and compared the effects of clazosentan 5 mg/h, 15 mg/h, and placebo starting the day after aneurysm repair. The analysis was performed separately based on the presence or absence of thick (≥4 mm) and diffuse (≥3 cisterns) SAH on admission computed tomography. The primary composite end point was all-cause mortality and vasospasm-related morbidity at 6 weeks, and the main secondary end point was the extended Glasgow Outcome Scale at 3 months, adjusted for admission clinical grade. Results- Of 1718 randomized patients, 919 (53%) had thi...Continue Reading

References

Oct 1, 1988·Stroke; a Journal of Cerebral Circulation·A HijdraH van Crevel
Apr 20, 2004·Critical Care Medicine·Jan ClaassenStephan A Mayer
Jun 26, 2004·Stroke; a Journal of Cerebral Circulation·Alejandro A RabinsteinEelco F M Wijdicks
Mar 8, 2006·Critical Care Medicine·Katja E WartenbergStephan A Mayer
Jul 11, 2006·Neurosurgery·Jennifer A FronteraStephan A Mayer
Jan 1, 1994·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·N W Dorsch, M T King
May 23, 2009·Stroke; a Journal of Cerebral Circulation·Kurt T KreiterR Loch Macdonald
Nov 26, 2009·Neurosurgery·Mellanie V SpringerStephan A Mayer
Feb 12, 2011·Stroke; a Journal of Cerebral Circulation·Mervyn D I VergouwenR Loch Macdonald
Feb 26, 2011·Stroke; a Journal of Cerebral Circulation·R Webster CrowleyR Loch Macdonald
Feb 14, 2012·Stroke; a Journal of Cerebral Circulation·R Loch MacdonaldStephan A Mayer
Mar 10, 2012·Stroke; a Journal of Cerebral Circulation·R Loch MacdonaldNeal Kassell
Apr 12, 2012·Stroke; a Journal of Cerebral Circulation·Rajat DharMichael Diringer
Aug 9, 2012·Stroke; a Journal of Cerebral Circulation·Mervyn D I VergouwenGabriel J E Rinkel
Oct 20, 2012·Critical Care : the Official Journal of the Critical Care Forum·Junpeng MaChao You
Dec 11, 2013·Nature Reviews. Neurology·R Loch Macdonald
May 23, 2014·Journal of Neurology, Neurosurgery, and Psychiatry·Karol P BudohoskiPeter J Kirkpatrick
Sep 4, 2015·Critical Care : the Official Journal of the Critical Care Forum·Hector LantiguaStephan A Mayer
Oct 1, 2015·Neurosurgery·Zahrah TaufiqueJ Michael Schmidt
Oct 16, 2016·Critical Care : the Official Journal of the Critical Care Forum·Charles L Francoeur, Stephan A Mayer
Nov 9, 2016·Stroke; a Journal of Cerebral Circulation·Oliver G S AylingR Loch Macdonald

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Citations

Nov 5, 2019·Hypertension·Matthias Barton, Masashi Yanagisawa
Mar 22, 2020·Journal of Clinical Medicine·Frederik C EnevoldsenMarcus Krüger
Nov 18, 2020·Neurocritical Care·Christopher MelinoskyNicholas A Morris

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