effect of clazosentan in patients with aneurysmal subarachnoid hemorrhage a meta-analysis of randomized controlled trials宣布效应对动脉瘤性蛛网膜下腔出血患者随机对照试验的荟萃分析.pdfVIP

Effect of Clazosentan in Patients with Aneurysmal Subarachnoid Hemorrhage: A Meta-Analysis of Randomized Controlled Trials 1. 1. 2 1 1 1 Xiang Wang , Yi-Ming Li , Wei-Qing Li , Cheng-Guang Huang *, Yi-Cheng Lu , Li-Jun Hou * 1 Department of Neurosurgery, Second Military Medical University, Changzheng Hospital, Shanghai, China, 2 Department of Pathology, Second Military Medical University, Changzheng Hospital, Shanghai, China Abstract Background: Cerebral vasospasm is the most important potentially treatable cause of mortality and morbidity following aneurysmal subarachnoid hemorrhage (aSAH). Clazosentan, a selective endothelinreceptor antagonist, has been suggested to help reduce the incidence of vasospasm in patients with aSAH. However, the results were controversial in previous trials. This meta-analysis attempts to assess the effect of clazosentan in patients with aSAH. Methodology/Principal Findings: We systematically searched Pubmed, Embase, and the Cochrane Library from their inception until June, 2012. All randomized controlled trials (RCTs) related to the effect of clazosentan in aSAH were included. The primary outcomes included the incidence of angiographic vasospasm, new cerebral infarction (NCI), delayed ischemic neurological deficits (DIND), and vasospasm-related morbidity/mortality (M/M); the second outcomes included the occurrence of rescue therapy, all-cause-mortality, and poor outcome. 4 RCTs were included with a total of 2156 patients. The risk of angiographic vasospasm (relative risk [RR] = 0.58; 95% CI, 0.48 to 0.71), DIND (RR = 0.76; 95% CI, 0.62 to 0.92), and vasospasm-related M/M (RR = 0.80; 95% CI, 0.67 to 0.96) were statistically significant