Abstract Details

Title Cilostazol Treatment and Serum Albumin Concentration in Patients with Aneurysmal Subarachnoid Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P8 - Poster Session 8 (5:30 PM-6:30 PM)

Poster/Presentation
Number 5-017

Objective We aimed to identify potential synergy between cilostazol use and serum albumin concentration measures in aneurysmal subarachnoid hemorrhage (aSAH) patients.

Background Cilostazol reduces the risks of cerebral ischemia related to vasospasm, angiographic vasospasm, new cerebral infarction, and death or disability in clinical studies. Higher serum albumin concentrations and IV albumin infusions are associated with reduction in occurrence of cerebral ischemia and the rate of death or disability in aSAH patients.

Design/Methods We analyzed data from a retrospective, observational cohort study using data from aSAH patients. We determined the effect of cilostazol use, baseline albumin concentration and magnitude of serum albumin concentration reduction within 2 weeks post aSAH on cerebral ischemia related to vasospasm and functional independence at discharge (modified Rankin scale [mRS] 0-2) and identified any interaction between cilostazol use and serum albumin measures after adjusting for potential confounders.

Results

Cilostazol use (odds ratio [OR]= 2.37) and baseline albumin concentration (OR= 5.15) were associated with higher odds (non-significant) of functional independence at discharge after adjusting for potential confounders. The magnitude of serum albumin concentration reduction was associated with lower odds functional independence at discharge (OR 0.06, 95% CI 0.002—0.77, p = 0.05). The interaction between cilostazol use and magnitude of serum albumin concentration reduction was significant (p=0.03). Among patients treated with cilostazol, one-unit reduction in magnitude of serum albumin concentration was associated with a median increase of approximately 3.3333 (95% CI -0.4621 to 4.2756) in the mRS at discharge.

Conclusions Our analysis raises the possibility that intravenous albumin infusion to ameliorate reduction in magnitude of serum albumin concentration may increase the rate of functional independence in aSAH patients.

Authors/Disclosures
Hamza I. Maqsood, MD (Dept of Neurology) PRESENTER	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
Shinsuke Muraoka (Kariya Toyota General Hospital)	No disclosure on file
Ryuta Saito	No disclosure on file
Abdullah Lodhi	No disclosure on file
Hamza Maqsood, MBBS (University of Missouri)	Mr. Maqsood has nothing to disclose.
Jonathan Beall	No disclosure on file
Christy Cassarly	No disclosure on file
Byron Gajewski	No disclosure on file
Renee Martin	No disclosure on file
Jose I. Suarez, MD, FAAN (Johns Hopkins Hospital)	Dr. Suarez has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Idorsia. Dr. Suarez has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for The Mayo Clinic.

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