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Balla HZ, Cao Y, Ström JO. Effect of Beta-Blockers on Stroke Outcome: A Meta-Analysis. Clin Epidemiol. 2021;13:225-236doi: 10.2147/CLEP.S268105.
Balla, H. Z., Cao, Y., & Ström, J. O. (2021). Effect of Beta-Blockers on Stroke Outcome: A Meta-Analysis. Clinical epidemiology, 13225-236. https://doi.org/10.2147/CLEP.S268105
Balla, Hajnal Zsuzsanna, et al. "Effect of Beta-Blockers on Stroke Outcome: A Meta-Analysis." Clinical epidemiology vol. 13 (2021): 225-236. doi: https://doi.org/10.2147/CLEP.S268105
Balla HZ, Cao Y, Ström JO. Effect of Beta-Blockers on Stroke Outcome: A Meta-Analysis. Clin Epidemiol. 2021 Mar 16;13:225-236. doi: 10.2147/CLEP.S268105. eCollection 2021. PMID: 33762851; PMCID: PMC7982440.
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Clin Epidemiol. 2021 Mar 16;13:225-236. doi: 10.2147/CLEP.S268105. eCollection 2021.

Effect of Beta-Blockers on Stroke Outcome: A Meta-Analysis.

Clinical epidemiology

Hajnal Zsuzsanna Balla, Yang Cao, Jakob O Ström

Affiliations

  1. Department of Neurology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  2. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
  3. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
  4. Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

PMID: 33762851 PMCID: PMC7982440 DOI: 10.2147/CLEP.S268105

Abstract

INTRODUCTION: Cardiovascular events and infections are common in the acute phase after stroke. It has been suggested that these complications may be associated with excessive sympathetic activation due to the stroke, and that beta-adrenergic antagonists (beta-blockers) therefore may be beneficial.

AIM: The aim of the current meta-analysis was to investigate the association between beta-blocker treatment in acute stroke and the three outcomes: mortality, functional outcome and post-stroke infections.

METHODS: A literature search was performed using the keywords stroke, cerebrovascular disorders, adrenergic beta-antagonists, treatment outcome and mortality. Randomized clinical trials and observational studies were eligible for data extraction. Heterogeneity was investigated using I

RESULTS: A total of 20 studies were eligible for at least one of the three outcomes. Two of the included studies were randomized controlled trials and 18 were observational studies. Quality assessments indicated that the risk of bias was moderate. The meta-analysis found no significant association between treatment with beta-blockers and any of the three outcomes. The studies analyzed for the outcomes mortality and infection were heterogeneous, while studies analyzed for functional outcome were homogeneous. The articles analyzed for mortality showed signs of publication bias.

CONCLUSION: The lack of significant effects in the current meta-analysis, comprising more than 100,000 patients, does not support the proposed beneficial effects of beta-blockers in the acute phase of stroke.

© 2021 Balla et al.

Keywords: beta-blockers; infection; mortality; outcome; stroke

Conflict of interest statement

Dr Jakob O Ström reports personal fees from Bayer AB, outside the submitted work. The authors report no other potential conflicts of interest for this work.

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