title: Systematic assessment and meta-analysis of the efficacy and safety of fasudil in the treatment of cerebral vasospasm in patients with subarachnoid hemorrhage.
abstract: OBJECTIVE
  Cerebral vasospasm (CVS) is a frequent and unpredictable complication in patients with subarachnoid hemorrhage (SAH) and often leads to poor outcomes. This study was aimed at evaluating the efficacy and safety of fasudil in the treatment of CVS in patients with SAH.
  
  
  METHODS
  A search was conducted using the full-text database of Chinese scientific journals, the Wanfang Database (January 1999 to November 2010), the Chinese Medical Association Digital Journal Database, PubMed, the Cochrane library, OVID, and EMBase (searching through November 2010).
  
  
  RESULTS
  A total of 8 studies met the inclusion criteria. The incidence rates of symptomatic CVS and CVS confirmed by angiography among the patients in the fasudil group were only 48% (odds ratio [OR] = 0.48, 95% confidence interval [CI]: 0.32-0.72, P = 0.0005) and 40% (OR = 0.40, 95% CI: 0.24-0-67, P = 0.0004) respectively of that of the control group. The odds ratios of cerebral infarction for all cases and cerebral infarction for CVS cases in the fasudil group were only 50% (OR = 0.50, 95% CI: 0.34-0.76, P = 0.0009) and 43% (OR = 0.43, 95% CI: 0.26-0.70, P = 0.0008) respectively of that of the control group.
  
  
  CONCLUSIONS
  Fasudil greatly reduces the occurrence of CVS and cerebral infarction in SAH patients, significantly improves the clinical outcomes of the patients (as assessed by the Glasgow Outcome Scale). Because of the limited number of trials and samples available for analysis, the conclusions from the present study still need to be validated with results from large randomized, controlled clinical trials.
authors.affiliation: Department of Neurology, Taihe Hospital Affiliated to Hubei University of Medicine, 32 Renmin Road, Shiyan City, Hubei Province 442000, China. yymclgj65@yahoo.com.cn
authors.forename: Guang Jian
authors.initials: GJ
authors.lastname: Liu
authors.forename: Zheng Jun
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Yun Fu
authors.initials: YF
authors.lastname: Wang
authors.forename: Li Li
authors.initials: LL
authors.lastname: Xu
authors.forename: Xiao Ling
authors.initials: XL
authors.lastname: Wang
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Guo Jun
authors.initials: GJ
authors.lastname: Luo
authors.forename: Guo Hou
authors.initials: GH
authors.lastname: He
authors.forename: Yan Jun
authors.initials: YJ
authors.lastname: Zeng
mesh_terms: D019307:1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D002544:Cerebral Infarction / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy*; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000188:drug therapy*; D054460:rho-Associated Kinases / Q000037:antagonists & inhibitors*
chemical_list: D047428:Protein Kinase Inhibitors; D019307:1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine; D054460:rho-Associated Kinases; C049347:fasudil