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Ischemic Stroke
Ischemic Stroke
1
/
2
carteolol X
ISA; long acting; also used
for glaucoma
carvedilol X
X -blocking activity
labetalol X X
ISA; -blocking activity
nadolol X X X X
long acting
penbutolol X X
ISA
pindolol X X
ISA; MSA
propranolol X X X X
MSA; prototypical beta-
blocker
sotalol
X
several other significant
mechanisms
timolol X X X X
primarily used for glaucoma
1
-selective
acebutolol X X X
ISA
atenolol X X X X
betaxolol X X X
MSA
bisoprolol X X X
esmolol X
X
ultra short acting; intra or
postoperative HTN
metoprolol X X X X X MSA
nebivolol X
relatively selective in most
patients; vasodilating (NO
release)
Abbreviations: HTN, hypertension; Arrhy, arrhythmias; MI, myocardial
infarction; CHF, congestive heart failure; ISA, intrinsic sympathomimetic
activity.
Beta-Blockers in Acute Ischemic Stroke
Karen L. Furie, MD reviewing Laowattana S and Oppenheimer
SM. Neurology 2007 Feb 13.
In this exploratory study, researchers examined potential benefits of beta-blockers
in acute ischemic stroke.
Acute stroke can increase sympathetic activity, a complication associated with
poor outcome. Beta-blockers inhibit the sympathetic response and have been
reported to reduce infarct volume in animal models. Researchers conducted this
case-control study to examine the effect of beta-blocker use on stroke severity.
They analyzed data collected on 111 subjects (average age, 62) within 14 days
(median, 3 days) after ischemic stroke onset; 22 subjects had been taking beta-
blockers and 89 had not. At study entry, the researchers used power spectral
analysis of heart rate variability (HRV) to estimate cardiac sympathovagal tone
and the Canadian Neurologic Scale to score stroke severity.
Of 22 variables assessed, only beta-blocker use was significantly associated with
stroke severity in univariate analyses. Beta-blockers remained an independent
predictor of stroke severity after controlling for age, sex, heart disease, aspirin and
statin use, and stroke subtype. Blood pressure was not included in the model.
Among 14 biomarker variables assessed to explore mechanisms of the beta-
blocker effect, erythrocyte sedimentation rate, thrombin level, and power spectral
analysis of HRV were significantly different in beta-blocker users and nonusers.
- See more at: http://www.jwatch.org/jn200706260000002/2007/06/26/beta-
blockers-acute-ischemic-stroke#sthash.RW6r8I8v.dpuf