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BackgroundAcute blood pressure (BP) reduction is standard of care after acute intracerebral haemorrhage (ICH). More acute BP reduction is associated with acute kidney injury (AKI). It is not known if the choice of antihypertensive medications affects the risk of AKI.MethodsWe analysed data from the ATACH-II clinical trial. AKI was defined by the Kidney Disease: Improving Global Outcomes criteria. We analysed antihypertensive medication from two sources. The first was a case report form that specified the use of labetalol, diltiazem, urapidil or other. We tested the hypothesis that the secondary medication was associated with AKI with χ2test. Second, we tested the hypotheses the dosage of diltiazem was associated with AKI using Mann-Whitney U test.ResultsAKI occurred in 109 of 1000 patients (10.9%). A higher proportion of patients with AKI received diltiazem after nicardipine (12 (29%) vs 21 (12%), p=0.03). The 95%ile (90%–99% ile) of administered diltiazem was 18 (0–130) mg in patients with AKI vs 0 (0–30) mg in patients without AKI (p=0.002). There was no apparent confounding by indication for diltiazem use.ConclusionsThe use of diltiazem, and more diltiazem, was associated with AKI in patients with acute ICH.

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Medicaid patients. We identified women with an index preterm birth who underwent a subsequent pregnancy. We then determined receipt of the following interventions: (i)17P, (ii) TVUS CL screening, (iii) cerclage, and (iv) VP based on pharmacy receipts for 17P and VP and billing codes for cerclage and TVUS CL screening. The proportion of women receiving >1 intervention was then determined. RESULTS: Overall, 1103 women with an index preterm birth received 17P in a subsequent pregnancy and 1455 received VP. Of women receiving 17P, 13.3% (n¼147) received a cerclage, 75.6% received TVUS CL screening, and 7.8% received VP (n¼86). Of women receiving vaginal progesterone, 12.0% received cerclage (n¼175). Compared to patients with Medicaid receiving 17P, patients with private insurance receiving 17P were significantly more likely to receive concurrent TVUS CL screening (84.3% versus 73.2%, p< 0.01), cerclage (18.2% versus 12.0%, p¼0.01), and VP (15.7% versus 5.6%, p< 0.01). CONCLUSION: Women with a prior preterm birth with private compared to Medicaid insurance were more likely to receive multiple concurrent preterm birth prevention interventions. Comparative effectiveness research evaluating benefit of concurrent interventions is needed to direct clinical care and resource utilization and optimize outcomes.