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Systematic assessment and meta-analysis of the efficacy and safety of fasudil in the treatment of cerebral vasospasm in patients with subarachnoid hemorrhage

Abstract

Purpose

Cerebral vasospasm (CVS) is a frequent and unpredictable complication in patients with subarachnoid hemorrhage (SAH) and often leads to poor outcomes. This study was aimed at evaluating the efficacy and safety of fasudil in the treatment of CVS in patients with SAH.

Methods

A search was conducted using the full-text database of Chinese scientific journals, the Wanfang Database (January 1999 to November 2010), the Chinese Medical Association Digital Journal Database, PubMed, the Cochrane library, OVID, and EMBase (searching through November 2010).

Results

A total of 8 studies met the inclusion criteria. The incidence rates of symptomatic CVS and CVS confirmed by angiography among the patients in the fasudil group were only 48% (odds ratio [OR] = 0.48, 95% confidence interval [CI]: 0.32–0.72, P = 0.0005) and 40% (OR = 0.40, 95% CI: 0.24-0–67, P = 0.0004) respectively of that of the control group. The odds ratios of cerebral infarction for all cases and cerebral infarction for CVS cases in the fasudil group were only 50% (OR = 0.50, 95% CI: 0.34–0.76, P = 0.0009) and 43% (OR = 0.43, 95% CI: 0.26–0.70, P = 0.0008) respectively of that of the control group.

Conclusions

Fasudil greatly reduces the occurrence of CVS and cerebral infarction in SAH patients, significantly improves the clinical outcomes of the patients (as assessed by the Glasgow Outcome Scale). Because of the limited number of trials and samples available for analysis, the conclusions from the present study still need to be validated with results from large randomized, controlled clinical trials.

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Acknowledgements

We are grateful to all the staff of American Journal Experts for language assistance and paper revision.

Conflict of interest

There was no conflict of interest among the authors.

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Correspondence to Guang Jian Liu.

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Liu, G.J., Wang, Z.J., Wang, Y.F. et al. Systematic assessment and meta-analysis of the efficacy and safety of fasudil in the treatment of cerebral vasospasm in patients with subarachnoid hemorrhage. Eur J Clin Pharmacol 68, 131–139 (2012). https://doi.org/10.1007/s00228-011-1100-x

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  • DOI: https://doi.org/10.1007/s00228-011-1100-x

Keywords

  • Fasudil
  • Subarachnoid hemorrhage
  • Cerebral vasospasm
  • Clinical outcome
  • Meta-analysis