London, United Kingdom 2013 Meta-analysis and reviews (PO 891 - 912) Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 817 890 Intracerebral/subarachnoid haemorrhage and venous diseases “Aggressive blood pressure lowering in acute intracerebral Hemorhage”(ICH): A retrospec-tive observational case series from Berkshire P. Boovalingam1, A. Vanwyk2, S. Seetharaman3, L. Barber4, E. Flossmann5, R. Nagarajan6, S. Khan7, F. Jeddy8, S. Thandeswaran9 Royal Berkshire NHS Foundation Trust, Reading, UNITED KINGDOM1, Royal Berkshire NHS Foundation Trust, Reading, UNITED KINGDOM2, Royal Berkshire NHS Foundation Trust, Reading, UNITED KINGDOM3, Royal Berkshire NHS Foundation Trust, Reading, UNITED KINGDOM4, Royal Berkshire NHS Foundation Trust, Reading, UNITED KINGDOM5, University Hospitals of Leicester NHS Trust, Leicester, UNITED KINGDOM6, Royal Berkshire NHS Foun-dation Trust, Reading, UNITED KINGDOM7, Royal Berkshire NHS Foundation Trust, Reading, UNITED KINGDOM8, Royal Berkshire NHS Foundation Trust, Reading, UNITED KINGDOM9 Background: Early elevation of blood pressure is very common after intracerebral haemorrhage (ICH) and is as-sociated with unfavourable outcome and several non randomised studies suggest that early lowering of blood pressure is beneficial in hypertensive patients with ICH. We aimed to assess whether this strategy is safe and feasible. Methods: From Feb 2010 to Dec 2011 data from 105 patients with ICH were collected retrospectively includ-ing temperature at admission to Acute Stroke Unit (ASU), Royal Berkshire NHS Foundation Trust Reading. Patients were divided into three main groups and based on their admission blood pressure (Group 1 BP<150 systolic, Group 2 BP 150-180 & Group 3 BP>180 systolic) in the ASU. All con-scious patients with BP >180 given amlodipine and labetalol for reduced GCS patients and any BP < 180 were monitored closely. The primary end point were neurological deterioration ( increase>/= 4 points from initial NIHSS within 72 hours ( estimated 90% CI) and secondary end points included poor outcome (mRS 3-6) including death at 90 days . Results: 105 patients (60 male (57.1%), mean age 73.8 & 93.3% (98/105) hypertensive) were found until Dec 2011. Of the total cohort, 51 (48.5%) had systolic BP>180 mmHg (Group 1), 23 (21.9%) had systolic BP 150-180mmHg (Group 2), and 31 (29.5%) had <150 mmHg (Group 3). In systolic BP > 180 group 37.2 % had neurological deterioration within 72 hours. Group 1 had a higher percentage of poor outcome (mRS 3-6) including mortality) (31/51 60.7%) compared to Group2 (9/2339.1% & Group 3(9/31 (29%)). In a multivariate model controlling for potential confounders (age, gender, and pre-morbid functional status) systolic BP >180 (OR, 1.2; 95% CI, 1.0-1.4) and systolic BP be-tween 150-180 (OR, 1.0; 95% CI, 0.8-1.4) augmented the probabilities of poor outcome Conclusions: SBP lowering (range 120-150 mmHg) using amlodipine or IV labetalol with tight BP monitoring seems to be safe and feasible for acute ICH. 891 Meta-analysis and reviews Association of Satins Use and Intracerebral Hemorrhage B. Wu1, C. Lei2, Y. Chen3, M. Liu4 Department of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA1, De-partment of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA2, Department of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA3, Department of Neurol-ogy, West China Hospital, Sichuan University, Chengdu, CHINA4 Objectives: Accumulating evidence suggests that statin have neuroprotective effects, but their as-sociation with ICH outcome has been conflicting. Some studies reported that Pre-ICH statin use or Post-ICH stain use reduced mortality or improved outcome after ICH; however, others failed to rep-licate this association. This study aimed to investigate the effect of Pre-ICH statin use or Post-ICH stain use on spontaneous intracerebral hemorrhage. Methods: To determine whether Pre-ICH statin use or Post-ICH stain use can affect function out-come and mortality, we conducted a systematic review of literature in the Cochrane Library, MED-LINE, EMBASE, and the China National Knowledge Infrastructure database. We also searched the reference lists of relevant studies and review articles. Results: Meta-analysis of 10 studies suggested that Pre-ICH statin use was not significantly associ-ated with 90-day mortality (OR 0.91, 95% CI 0.80 to 1.02); 2 studies showed Pre-ICH statin use did not significantly add 30-day mortality (OR 1.20, 95% CI 0.73 to 1.97); seven studies suggested Pre- ICH statin use was no significance of modified Rankin Scale (4-6) (OR 0.93, 95% CI 0.79 to 1.09); three studies showed Pre-ICH statin did not markedly increase hematoma volume (SMD3.04, 95% CI-1.25 to 7.33 ). However, 2 studies explained that Post-ICH stain did not significantly add the dis-charge mortality (OR 1.19, 95% CI 0.71 to 1.98). Conclusion: Pre-ICH statin use was not associated with functional outcome or mortality of ICH. Post-ICH statin use was not associated with an increased risk of discharge mortality.
Karger_ESC London_2013
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