Do endothelin-receptor antagonists prevent delayed neurological deficits and poor outcomes after aneurysmal subarachnoid hemorrhage?
A meta-analysis. Stroke 2009 Aug 13. (Epub ahead of print) Methods: We performed a systematic review and meta-analysis of randomized controlled trials assessing the use of endothelin-receptor antagonists (ETRAs) in patients with SAH. Without language restrictions, we systematically searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (1950 to the present). We also searched the references of selected papers, the proceedings of the International Stroke Conference (2007 to 2009), and Google Scholar. Registered clinical trials were sought at http://www.who.int/trialsearch/. Results: Three studies met eligibility criteria, enrolling 867 patients. ETRAs significantly reduced the occurrence of DINDs (OR 0.68 [0.49 to 0.95]) and radiographic vasospasm (OR 0.31 [0.19 to 0.49]), but did not have any impact on mortality (OR 1.09 [0.69 to 1.72]) or poor neurological outcomes (OR 0.87 [0.63 to 1.20]). Any benefit of ETRAs may have been partially offset by adverse effects
