title: Common drugs in acute ischemic stroke and their influence on outcome: an observational study in 1013 stroke patients.
abstract: OBJECTIVE
  Various drugs, when used during acute stroke, may affect stroke outcome. Some advise against the use of certain drugs that may be potentially harmful when used in acute stroke. However, for many of such drugs, the evidence is scarce. Therefore, we studied the use of various drugs at stroke onset as independent predictors of outcome at 3 months.
  
  
  METHODS
  In an observational study of 1013 acute ischemic stroke patients, medication on admission was registered and divided in 10 categories. Functional outcome at 3 months was rated using the modified Rankin scale as functional independent (Rankin 0, 1, and 2) or as functional dependent or dead (Rankin 3, 4, and 5, or 6). Independent predictive values of medication use on outcome were analyzed using multivariate regression modeling.
  
  
  RESULTS
  Vasodilator use was independently associated with less favorable functional outcome at 3 months (odds ratio [OR], 0.37 [95% confidence interval {CI}, 0.16-0.89]; P = 0.025) in lacunar stroke, as was the use of diuretics (OR, 0.43 [95% CI, 0.22-0.82]; P = 0.010) in atherothrombotic stroke. Calcium antagonists were independently associated with better outcome at 3 months (OR, 2.64 [95% CI, 1.04-6.69]; P = 0.042) in cardioembolic stroke.
  
  
  CONCLUSIONS
  Our study does not yield strong evidence in favor of testing various commonly used drugs as potential neuroprotectives in acute stroke.
authors.affiliation: Department of Neurology, Reinier de Graaf Gasthuis, Reinier de Graafweg, Delft, Holland.
authors.forename: Leo
authors.initials: L
authors.lastname: Aerden
authors.forename: Elizabeth
authors.initials: E
authors.lastname: van Raak
authors.forename: Anita
authors.initials: A
authors.lastname: Boreas
authors.forename: Alfons
authors.initials: A
authors.lastname: Kessels
authors.forename: Jan
authors.initials: J
authors.lastname: Lodder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000145:classification / Q000627:therapeutic use*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation / Q000379:methods*; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents