Beta-blockers, plasma total creatine kinase and creatine kinase myocardial isoenzyme, and the prognosis of subarachnoid hemorrhage.
Under double-blind randomized conditions the effects of early intervention with oral propranolol or a placebo were studied in 51 cases of subarachnoid hemorrhage. Eleven out of 23 patients randomly assigned to placebo had a poor outcome at 6 months, while 2 of the 28 patients randomly assigned to propranolol had a poor outcome (p less than 0.001). Patients with a poor outcome on the placebo had significantly higher mean plasma total creatine kinase levels (742 IU, standard error of the mean +/- 233 IU) on the fifth day after subarachnoid hemorrhage than patients with a good outcome on the placebo (108 +/- 20 IU; p less than 0.05). A raised plasma creatine kinase myocardial isoenzyme was associated with a particularly poor outlook in patients receiving the placebo, in contrast to those taking a beta-blocker. Clinical outcome and plasma creatine kinase levels in patients taking atenolol (hydrophilic) were similar to those observed in patients receiving propranolol.
Neil-Dwyer
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Cruickshank
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Stratton
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D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001262:Atenolol / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003402:Creatine Kinase / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011379:Prognosis; D011433:Propranolol / Q000627:therapeutic use*; D011897:Random Allocation; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy* / Q000201:enzymology
D000319:Adrenergic beta-Antagonists; D007527:Isoenzymes; D010919:Placebos; D001262:Atenolol; D011433:Propranolol; D003402:Creatine Kinase