Effect of β-Adrenergic Antagonists on In-Hospital Mortality after Ischemic Stroke

Background: Ischemic stroke accounts for 85%-90% of all strokes and currently has very limited therapeutic options. Recent studies of beta-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 beta-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 beta-adrenergic antagonists both at home and during the first 3 days of hospitalization were compared with patients who were not on beta-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 beta-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 beta-adrenergic antagonists (odds ratio, .657; 95% confidence interval, .655-.658). Conclusions: The continuation of home beta-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 beta-blockers after ischemic stroke. (C) 2015 by National Stroke Association