Pre-stroke use of antihypertensives, antiplatelets, or statins and early ischemic stroke outcomes.
BACKGROUND
The effect of pre-stroke use of antihypertensives, antiplatelets, and statins on initial severity and early outcome of ischemic stroke is uncertain.


METHODS
We performed a retrospective chart review of 553 consecutive acute ischemic stroke patients presenting to the Montreal General Hospital between April 1st 2002 and October 15th 2005. We defined a severe stroke as a Canadian Neurological Scale score of < or =7 and a poor early outcome as a modified Rankin Scale score of >3 at 10 days post-stroke.


RESULTS
In total, 339 patients were included. Superior early functional outcome was associated with the premorbid use of statins (OR = 0.50, 95% CI: 0.25-1.00) and the combination of all 3 medications (OR = 0.37, 95% CI: 0.16-0.87). Angiotensin-II-decreasing agents were associated with an increased risk of severe strokes (OR = 2.13, 95% CI: 1.00-4.52).


CONCLUSIONS
Pre-stroke use of statins and the combination of antihypertensives, antiplatelets, and statins were both associated with a favorable functional outcome at 10 days post-stroke. Angiotensin-II-decreasing agents were associated with increased initial stroke severity.
Yu
Amy Y X
AY
McGill University, Montreal, Que., Canada.
Keezer
Mark R
MR
Zhu
Bin
B
Wolfson
Christina
C
Côté
Robert
R
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000804:Angiotensin II / Q000819:agonists / Q000037:antagonists & inhibitors; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011379:Prognosis; D011792:Quebec; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology* / Q000517:prevention & control
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D000804:Angiotensin II