The impact of home medications on the risk of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

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OBJECTIVE: Delayed cerebral ischemia (DCI) is one of the most severe complications following aneurysmal subarachnoid hemorrhage (SAH) and can significantly worsen clinical outcomes. This study aimed to analyze the association between patients' home medications and the risk of cerebral infarction and poor functional outcomes after SAH. METHODS: This retrospective analysis included 995 patients with aneurysmal SAH treated at our clinic between January 2003 and June 2016. Various demographic and clinical baseline characteristics were examined, with a particular focus on regular use of home medications. The study endpoints were the occurrence of early (within 72 h post-SAH) and DCI-related infarcts (> 72 h) in follow-up computed tomography scans, as well as the functional disability at six months, defined as a modified Rankin Scale > 2. RESULTS: There was no association between the occurrence of early infarcts and patients' regular medications. In contrast, individuals with calcium channel blockers (CCB) use (n = 93) showed a higher rate of DCI (32.6% vs 19.3%, p = 0.005) and 6-months functional disability (57.8% vs 46.8%, p = 0.048). In multivariable analysis, CCB use was independently associated with the risk of DCI (adjusted odds ratio [aOR] = 4.05; p < 0.0001) and functional disability after six months (aOR = 2.73; p = 0.036). CONCLUSIONS: Regular CCB use was independently associated with an increased risk of DCI and functional disability at six months. These findings warrant cautious interpretation and further validation in prospective studies.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.