Common drugs in acute ischemic stroke and their influence on outcome: an observational study in 1013 stroke patients.
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.
Aerden
Leo
L
Department of Neurology, Reinier de Graaf Gasthuis, Reinier de Graafweg, Delft, Holland.
van Raak
Elizabeth
E
Boreas
Anita
A
Kessels
Alfons
A
Lodder
Jan
J
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
D002317:Cardiovascular Agents