title: Effect of β-Adrenergic Antagonists on In-Hospital Mortality after Ischemic Stroke.
abstract: BACKGROUND
  Ischemic stroke accounts for 85%-90% of all strokes and currently has very limited therapeutic options. Recent studies of β-adrenergic antagonists suggest they may have neuroprotective effects that lead to improved functional outcomes in rodent models of ischemic stroke; however, there are limited data in patients. We aimed to determine whether there was an improvement in mortality rates among patients who were taking β-blockers during the acute phase of their ischemic stroke.
  
  
  METHODS
  A retrospective analysis of a prospectively collected database of ischemic stroke patients was performed. Patients who were on β-adrenergic antagonists both at home and during the first 3 days of hospitalization were compared with patients who were not on β-adrenergic antagonists to determine the association with patient mortality rates.
  
  
  RESULTS
  The study included a patient population of 2804 patients. In univariate analysis, use of β-adrenergic antagonists was associated with older age, atrial fibrillation, hypertension, and more-severe initial stroke presentation. Despite this, multivariable analysis revealed a reduction in in-hospital mortality among patients who were treated with β-adrenergic antagonists (odds ratio, .657; 95% confidence interval, .655-.658).
  
  
  CONCLUSIONS
  The continuation of home β-adrenergic antagonist medication during the first 3 days of hospitalization after an ischemic stroke is associated with a decrease in patient mortality. This supports the work done in rodent models suggesting neuroprotective effects of β-blockers after ischemic stroke.
authors.affiliation: University of Connecticut School of Medicine, Farmington.
authors.forename: Christopher
authors.initials: C
authors.lastname: Phelan
authors.affiliation: University of Connecticut School of Medicine, Farmington.
authors.forename: Vivek
authors.initials: V
authors.lastname: Alaigh
authors.affiliation: Research Program, Hartford Hospital, Hartford.
authors.forename: Gil
authors.initials: G
authors.lastname: Fortunato
authors.affiliation: Research Program, Hartford Hospital, Hartford.
authors.forename: Ilene
authors.initials: I
authors.lastname: Staff
authors.affiliation: University of Connecticut School of Medicine, Farmington; Department of Neurology, Hartford Hospital, University of Connecticut Health Center, Farmington, CT. Electronic address: lauren.sansing@yale.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Sansing
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality*; D015996:Survival Rate
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: Ischemic stroke; catecholamines; mortality; β-adrenergic antagonists