Effect ofβ1 -blocker therapy on the risk of infections and death after acute stroke

doi:10.3969/j.issn.1002-1949.2015.09.012

Abstract：Objective To investigate the effect of β1 -blocker therapy on the risk of infections and death after stroke in human .Methods A total of 125 patients with ischemic or hemorrhagic stroke , admitted to our hospital stroke unit from 2012 January to 2014 June, were included in this historical cohort study .Subjects were divided into β1 -blocker group ( therapy group ) and no -β1 -Blocker ( control group ) .iNKT value was detected in patients by flow cytometry .The effect of β1 -blocker therapy on post -stroke pneumonia , urinary tract infections and death was investigated using multivariable Poisson and Cox regression models .Results One hundred and ten (88.3%) patients were admitted with ischemic stroke, the remaining 15 (11.7%) patients had a hemorrhagic stroke. Median baseline NIHSS was 8 ( 5 ~16 ) points.Sixty ( 48.2%) patients received beta -blocker therapy .There was no difference in the risk of post -stroke pneumonia between patients with and withoutβ1 -blocker therapy (RR=1.00, 95% CI 0.77 ~1.30, P=0.995).Patients with β1 -blocker therapy showed a decreased risk for urinary tract infections ( RR=0.65, 95% CI 0.43~0.98, P=0.040).7-days mortality did not differ between groups (HR =1.36, 95% CI 0.65 ~2.77, P=0.425), while patients with β1 -blocker therapy showed a higher 30 -days mortality (HR=1.93, 95%CI 1.20~3.10, P=0.006).There was no significant difference in iNKT values between the patients with pneumonia and urinary tract infection , and the iNKT value in the urinary tract infection group was significantly lower than the pneumonia group (P<0.05).Conclusion β1 -blocker therapy does not reduce the risk for post -stroke pneumonia , but significantly reduces the risk for urinary tract infections .