PRELIMINARY DATA FROM CLEVIDIPINE ADMINISTRATION VERSUS OTHER ANTIHYPERTENSIVE TREATMENTS IN PATIENTS WITH ACUTE HYPERTENSIVE INTRACEREBRAL HEMORRHAGE.

Abstract

Background and Aims: Intracerebral haemorrhage (ICH) has been associated with worse functional outcome and increased mortality, related to hematoma volume and expansion. Blood pressure (BP) reduction may attenuate hematoma expansion. We sought to investigate whether clevidipine, an intravenous administered calcium-channel blocker, achieved better ICH volume reduction and better functional outcome in patients with hypertensive ICH compared to standard-of-care antihypertensive treatment.

Methods: This is a prospective case-control study, assessing the clinical severity, the hematoma size differentiation and the clinical outcome in patients with hypertensive ICH, who received intravenous clevidipine in the acute phase versus standard-of-care antihypertensive treatment (clonidine and/or labetalol).

Results: This study included forty-four ICH patients (clevidipine-group: 17 – controls: 27). There was no difference in demographic characteristics and admission National Institutes of Health Stroke Scale (NIHSS) score. A statistically significant ICH volume change on 24h follow-up brain computed tomography was observed in the clevidipine group (11.8% reduction vs 0.4% increase in the control-group; p-value: 0.04). Moreover, a non-significant trend towards NIHSS-score improvement at discharge was observed in clevidipine group [ΔNIHSS score 4 (1-7) in the clevidipine group vs 2 (0-4) in the control group], whereas functional outcomes and mortality at 3 months were similar. No serious adverse events were detected among patients treated with clevidipine.

Conclusions: The present study highlights that clevidipine represents a safe and effective alternative in terms of hypertension control among ICH patients in the acute phase. However, these findings, indicating superiority of clevidipine, require confirmation in larger studies.