Prior TIA, lipid-lowering drug use, and physical activity decrease ischemic stroke severity.
OBJECTIVE
To determine clinical and pharmacologic factors that could influence the initial severity and short-term outcome of cerebral ischemia.


METHODS
In a cross-sectional hospital-based study of patients with acute supratentorial ischemic stroke, we systematically collected medical history, previous leisure-time physical activity, current and previous treatments, blood pressure, temperature, blood glucose, fibrinogen, NIH Stroke Scale (NIHSS) score at admission, and outcome at day 8. Factors potentially associated with initial stroke severity and outcome were selected by univariate analyses and then validated in logistic regression analyses with lower severity of stroke at admission (NIHSS 0 to 5) or good outcome at day 8 (modified Rankin Scale 0 to 1, Barthel Index 95 to 100) as dependent variables.


RESULTS
In 362 consecutive patients (median age 70 years, range 16 to 97 years; 195 women), independent factors associated with a lower severity at admission were previous leisure-time physical activity (adjusted odds ratio [OR] 1.67, 95% CI 1.07 to 2.66), TIA (adjusted OR 2.28, 95% CI 1.06 to 4.87) and treatment with lipid-lowering drug (adjusted OR 1.76, 95% CI 1.02 to 3.03). Previous treatment with lipid-lowering drug and leisure-time physical activity were also independent factors associated with a good short-term outcome.


CONCLUSIONS
Both regular physical activity and lipid-lowering drugs should be prospectively evaluated to determine whether they reduce the severity of ischemic stroke.
Deplanque
D
D
Department of Pharmacology, EA 1046, Institut de Médecine Prédictive et de Recherche Thérapeutique, University Hospital of Lille, France.
Masse
I
I
Lefebvre
C
C
Libersa
C
C
Leys
D
D
Bordet
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D002546:Ischemic Attack, Transient / Q000150:complications*; D007899:Leisure Activities; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009043:Motor Activity; D017063:Outcome Assessment, Health Care; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology*
D000960:Hypolipidemic Agents