naa a22 4500 510799418 CHVBK 20180411083348.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12028-013-9863-9 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9863-9 A Prospective Evaluation of Labetalol Versus Nicardipine for Blood Pressure Management in Patients with Acute Stroke [Elektronische Daten] [Xi Liu-DeRyke, Phillip Levy, Dennis Parker Jr., William Coplin, Denise Rhoney] Introduction: Acute hypertension is common following stroke and contributes to poor outcomes. Labetalol and nicardipine are often used for acute hypertension but there are little data comparing the two. This study is to evaluate the therapeutic response and tolerability of these two agents following acute stroke. Methods: This is a prospective, pseudo-randomized study comparing labetalol and nicardipine for blood pressure (BP) management in acute stroke patients. Patients who presented to the emergency department (ED) with confirmed hemorrhagic or ischemic stroke received either labetalol or nicardipine for 24h from ED admission. Therapeutic response was assessed by achievement of goal BP, time spent within goal, and variability in BP. Clinical outcomes including length of stay, clinical status at discharge, and in-hospital mortality were recorded. Results: 54 patients were enrolled (labetalol=28; nicardipine=26) with 25±6 BP measurements per patient. Majority of patients had a hemorrhagic stroke and baseline characteristics were similar between groups. All patients who received nicardipine achieved goal BP compared to 17 (61%) in the labetalol group (p<0.001) with 89% nicardipine-treated patients achieved goal BP within 60min of drug initiation versus 25% in labetalol group (p<0.001). Nicardipine group had better maintenance of BP, a greater percentage of time spent within goal, and significantly less BP variability compared to labetalol group (p<0.001). Less rescue antihypertensive agents were given to nicardipine group than labetalol group (p<0.001). The incidences of adverse drug events were similar between groups and there were no differences in clinical outcomes. Conclusion: In acutely hypertensive stroke patients, superior therapeutic response was achieved with nicardipine versus labetalol. Despite this, there was no demonstrable difference in clinical outcomes. Springer Science+Business Media New York, 2013 Labetalol nationallicence Nicardipine nationallicence Acute hypertension nationallicence Acute stroke nationallicence Stroke nationallicence Blood pressure nationallicence Liu-DeRyke Xi Orlando Regional Medical Center, Orlando, FL, USA aut Levy Phillip Department of Emergency Medicine, Wayne State University, Detroit, MI, USA aut Parker Jr. Dennis Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA aut Coplin William Neurocritical Care Neuroscience Administration, St. Anthony Hospital/Centura Health, 11600 W 2nd Dr., 80228, Lakewood, CO, USA aut Rhoney Denise Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, 115 Beard Hall, Campus Box 7574, 27599, Chapel Hill, NC, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 41-47 1541-6933 19:1<41 2013 19 12028 https://doi.org/10.1007/s12028-013-9863-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9863-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Liu-DeRyke Xi Orlando Regional Medical Center, Orlando, FL, USA aut NATIONALLICENCE 700 1- Levy Phillip Department of Emergency Medicine, Wayne State University, Detroit, MI, USA aut NATIONALLICENCE 700 1- Parker Jr Dennis Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA aut NATIONALLICENCE 700 1- Coplin William Neurocritical Care Neuroscience Administration, St. Anthony Hospital/Centura Health, 11600 W 2nd Dr., 80228, Lakewood, CO, USA aut NATIONALLICENCE 700 1- Rhoney Denise Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, 115 Beard Hall, Campus Box 7574, 27599, Chapel Hill, NC, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 41-47 1541-6933 19:1<41 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer