In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 55, No. Suppl_1 ( 2024-02)
Abstract:
Background: The efficacy of beta-blockers in acute ischemic stroke remains ambiguous. Research targeting high-risk patients, especially those with elevated heart rates, is crucial. Methods: A comprehensive multicenter registry of acute ischemic stroke patients was integrated with the National Health Insurance Service database. We focused on patients exhibiting a heart rate of ≥100 bpm between days 3-7 post-symptom onset. These patients were categorized based on whether they received a beta-blocker prescription by day 8. To account for potential imbalances, we employed Cox’s proportional hazard model with inverse-probability of treatment weighting based on propensity score. The primary outcome was composite of stroke recurrence, myocardial infarction, and mortality within a year post-stroke. Recognizing the significant discontinuation rate of beta-blockers, we conducted an additional analysis on persistent users and landmark analysis at 2-month, 1-year, and 2-year intervals. Results: Out of 5,049 patients, 1,623 (32.1%) were prescribed with beta-blockers by the 8th day. Beta-blocker usage did not significantly influence the primary outcome within the first year (IPTW adjusted HR [95% CI], 0.98 [0.86-1.12] ). However, patients who consistently used beta-blockers beyond 2 months exhibited a reduced mortality risk (adjusted HR, 0.88 [0.78-0.99]). Landmark analysis further revealed that consistent beta-blocker usage notably decreased mortality risk at 8-day to 2-month (IPTW adjusted HR [95% CI] , 0.80 [0.69-0.93]) and 2-month to 1-year intervals (IPTW adjusted HR [95% CI] , 0.80 [0.68-0.94]). Conclusion: Our findings suggest that beta-blockers can potentially reduce mortality in acute ischemic stroke patients, with consistent usage being a pivotal factor.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/str.55.suppl_1.TMP107
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2024
detail.hit.zdb_id:
1467823-8
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