Jason J Chang1, Yasser Khorchid2, Ali Kerro2, L Goodwin Burgess3, Nitin Goyal2, Anne W Alexandrov4, Andrei V Alexandrov2, Georgios Tsivgoulis5. 1. Department of Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address: jason.chang@medstar.net. 2. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA. 3. University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA. 4. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA; Australian Catholic University, Sydney, Australia. 5. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA; Second Department of Neurology, Attikon University Hospital, School of Medicine, University of Athens, Athens, Greece.
Abstract
PURPOSE: Intracerebral hemorrhage (ICH) is associated with poor clinical outcome and high mortality. Sulfonylurea (SFU) use may be a viable therapy for inhibiting sulfonylurea receptor-1 and NCCa-ATP channels and reducing perihematomal edema and blood-brain barrier disruption. We sought to evaluate the effects of prehospital SFU use with outcomes in diabetic patients with acute ICH. METHODS: We retrospectively analyzed a cohort of diabetic patients presenting with acute ICH at a tertiary care center. Study inclusion criteria included spontaneous ICH etiology and age>18years. Baseline clinical severity was documented using ICH-score. Hematoma volumes (HV) on admission were calculated using ABC/2 formula. Unfavorable functional outcome was documented as discharge modified Rankin Scale scores 2-6. RESULTS: 230 diabetic patients with acute ICH fulfilled inclusion criteria (mean age 64±13years, men 53%). SFU pretreatment was documented in 16% of the study population. Patients with SFU pretreatment had significantly (p<0.05) lower median ICH-scores (0, IQR: 0-2) and median admission HV (4cm3, IQR: 1-12) compared to controls [ICH-score: 1 (IQR: 0-3); HV: 9cm3 (IQR: 3-20)]. SFU pretreatment was independently (p=0.033) and negatively associated with the cubed root of admission HV (linear regression coefficient: -0.208; 95%CI: -0.398 to -0.017) in multiple linear regression analyses adjusting for potential confounders. Pretreatment with SFU was also independently (p=0.033) associated with lower likelihood of unfavorable functional outcome (OR=0.19; 95%CI: 0.04-0.88) in multivariable logistic regression models adjusting for potential confounders. CONCLUSION: SFU pretreatment may be an independent predictor for improved functional outcome in diabetic patients with acute ICH. This association requires independent confirmation in a large prospective cohort study.
PURPOSE:Intracerebral hemorrhage (ICH) is associated with poor clinical outcome and high mortality. Sulfonylurea (SFU) use may be a viable therapy for inhibiting sulfonylurea receptor-1 and NCCa-ATP channels and reducing perihematomal edema and blood-brain barrier disruption. We sought to evaluate the effects of prehospital SFU use with outcomes in diabeticpatients with acute ICH. METHODS: We retrospectively analyzed a cohort of diabeticpatients presenting with acute ICH at a tertiary care center. Study inclusion criteria included spontaneous ICH etiology and age>18years. Baseline clinical severity was documented using ICH-score. Hematoma volumes (HV) on admission were calculated using ABC/2 formula. Unfavorable functional outcome was documented as discharge modified Rankin Scale scores 2-6. RESULTS: 230 diabeticpatients with acute ICH fulfilled inclusion criteria (mean age 64±13years, men 53%). SFU pretreatment was documented in 16% of the study population. Patients with SFU pretreatment had significantly (p<0.05) lower median ICH-scores (0, IQR: 0-2) and median admission HV (4cm3, IQR: 1-12) compared to controls [ICH-score: 1 (IQR: 0-3); HV: 9cm3 (IQR: 3-20)]. SFU pretreatment was independently (p=0.033) and negatively associated with the cubed root of admission HV (linear regression coefficient: -0.208; 95%CI: -0.398 to -0.017) in multiple linear regression analyses adjusting for potential confounders. Pretreatment with SFU was also independently (p=0.033) associated with lower likelihood of unfavorable functional outcome (OR=0.19; 95%CI: 0.04-0.88) in multivariable logistic regression models adjusting for potential confounders. CONCLUSION:SFU pretreatment may be an independent predictor for improved functional outcome in diabeticpatients with acute ICH. This association requires independent confirmation in a large prospective cohort study.
Authors: Ruchira M Jha; Anupama Rani; Shashvat M Desai; Sudhanshu Raikwar; Sandra Mihaljevic; Amanda Munoz-Casabella; Patrick M Kochanek; Joshua Catapano; Ethan Winkler; Giuseppe Citerio; J Claude Hemphill; W Taylor Kimberly; Raj Narayan; Juan Sahuquillo; Kevin N Sheth; J Marc Simard Journal: Int J Mol Sci Date: 2021-11-02 Impact factor: 5.923
Authors: Nitin Goyal; Georgios Tsivgoulis; Konark Malhotra; Alexander L Houck; Yasser M Khorchid; Abhi Pandhi; Violiza Inoa; Khalid Alsherbini; Andrei V Alexandrov; Adam S Arthur; Lucas Elijovich; Jason J Chang Journal: J Am Heart Assoc Date: 2018-04-13 Impact factor: 5.501