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Associations between drug treatments and the risk of aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis

There is increasing interest in drug therapy for preventing aneurysmal subarachnoid hemorrhage (aSAH). We aimed to comprehensively evaluate the association between drug use and the risk of aSAH. We searched PubMed and Scopus from the databases’ inception until December 2021. Observational studies re...

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Main Authors: Shimizu, Kampei (Author) , Aoki, Tomohiro (Author) , Etminan, Nima (Author) , Hackenberg, Katharina (Author) , Tani, Shoichi (Author) , Imamura, Hirotoshi (Author) , Kataoka, Hiroharu (Author) , Sakai, Nobuyuki (Author)
Format: Article (Journal)
Language:English
Published: December 2023
In: Translational stroke research
Year: 2023, Volume: 14, Issue: 6, Pages: 833-841
ISSN:1868-601X
DOI:10.1007/s12975-022-01097-2
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s12975-022-01097-2
Verlag, lizenzpflichtig, Volltext: https://link.springer.com/article/10.1007/s12975-022-01097-2
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Author Notes:Kampei Shimizu, Tomohiro Aoki, Nima Etminan, Katharina A. M. Hackenberg, Shoichi Tani, Hirotoshi Imamura, Hiroharu Kataoka, Nobuyuki Sakai
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Summary:There is increasing interest in drug therapy for preventing aneurysmal subarachnoid hemorrhage (aSAH). We aimed to comprehensively evaluate the association between drug use and the risk of aSAH. We searched PubMed and Scopus from the databases’ inception until December 2021. Observational studies reporting the association between any drug therapy and aSAH were included. The odds ratios (ORs) for each drug used in aSAH were meta-analyzed with a random-effect model. According to the systematic review, 25 observational studies were eligible for the present study. Four therapeutic purpose-based classes (e.g., lipid-lowering agents) and 14 mechanism-based classes (e.g., statins) were meta-analyzed. Anti-hypertensive agents (OR, 0.50; 95% confidence interval [95% CI], 0.33-0.74), statins (OR, 0.55; 95% CI, 0.35-0.85), biguanides (OR, 0.57; 95% CI, 0.34-0.96), and acetylsalicylic acid (ASA) (OR, 0.62; 95% CI, 0.41-0.94) were inversely associated with the risk of aSAH. Non-ASA non-steroidal anti-inflammatory drugs (OR, 1.73; 95% CI, 1.07-2.79), selective cyclooxygenase-2 inhibitors (OR, 2.04; 95% CI, 1.24-3.35), vitamin K antagonists (OR, 1.50; 95% CI, 1.18-1.91), and dipyridamole (OR, 1.77; 95% CI, 1.23-2.54) were positively associated with the incidence of aSAH. There was also a trend toward a positive association between glucocorticoids (OR, 1.38; 95% CI, 0.97-1.94) and aSAH. The present study suggests that anti-hypertensive agents, statins, biguanides, and ASA are candidate drugs for preventing aSAH. By contrast, several drugs (e.g., anti-thrombotic drugs) may increase the risk of aSAH. Thus, the indications of these drugs in patients with intracranial aneurysms should be carefully determined.
Item Description:Online veröffentlicht: 15. Oktober 2022
Gesehen am 29.07.2024
Physical Description:Online Resource
ISSN:1868-601X
DOI:10.1007/s12975-022-01097-2

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