Prostacyclin and analogues for acute ischaemic stroke.
BACKGROUND
Prostacyclin is an agent with a number of effects on platelets, blood vessels and nerve cells which might improve outcome after acute ischaemic stroke.


OBJECTIVE
The objective of this review was to assess the effect of prostacyclin or analogues on survival in people with acute ischaemic stroke.


METHODS
We searched the Cochrane Stroke Group trials register (last searched: March 1999), Medline (from 1965), Embase (from 1980) and ISI (from 1981). We contacted drug companies.


METHODS
Randomised trials comparing prostacyclin or analogues with placebo or control. Trials where people were entered within one week of stroke onset were included.


METHODS
Trial quality was assessed.


RESULTS
Five trials involving 191 people were included. Six early deaths (within four weeks) occurred with prostacyclin and nine with placebo (odds ratio of 0.63, 95% confidence interval 0.22 to 1.85). One trial of 32 patients reported late deaths (by 10 to 18 months) in 50% of patients in each group.


CONCLUSIONS
Too few patients have been studied in randomised trials to allow conclusions to be drawn about the effect of prostacyclin treatment on survival of people with acute stroke.
Bath
P M
PM
Division of Stroke Medicine, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, Nottinghamshire, UK, NG5 1PB. philip.bath@nottingham.ac.uk
Bath
F J
FJ
D002545:Brain Ischemia / Q000188:drug therapy; D011464:Epoprostenol / Q000627:therapeutic use*; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D020521:Stroke / Q000188:drug therapy*
D010975:Platelet Aggregation Inhibitors; D011464:Epoprostenol