Effects of clinical and laboratory variables and of pretreatment with cardiovascular drugs in acute ischaemic stroke: a retrospective chart review from the GIFA study.
BACKGROUND
Few studies have examined the role of cardiovascular drugs on acute ischaemic stroke prognosis.


OBJECTIVE
To evaluate the relationship between a favourable outcome in patients with acute ischaemic stroke and specific demographic, clinical and laboratory variables and cardiovascular drug pretreatment.


METHODS
The 1096 patients enrolled in the GIFA study (who had a main discharge diagnosis of ischaemic stroke) represent the final patient sample used in this analysis. Drugs considered in the analysis included angiotensin converting enzyme (ACE)-inhibitors, angiotensin II receptor blockers, statins, calcium channel blockers, anti-platelet drugs, vitamin K antagonists and heparins. The outcomes analyzed included in-hospital mortality, cognitive function evaluated by the Hodkinson Abbreviated Mental Test (HAMT), and functional status evaluated by activities of daily living (ADL). The definition of a good outcome was no in-hospital mortality, a HAMT score of ≥ 6 and no ADL impairment.


RESULTS
Patients with no in-hospital mortality, a HAMT score of >6 and no ADL impairment were more likely to be younger at baseline and have a lower blood glucose level and a systolic blood pressure (SBP) between 120 and 180 mmHg, a higher plasma total cholesterol level, a lower white blood cell count, and a lower Charlson Index (CI) score, a higher rate of pretreatment with ACE-inhibitors, calcium channel blockers and a lower rate of pretreatment with heparin.


CONCLUSIONS
Predictors of good outcome, in terms of in-hospital mortality and cognitive and functional performance at discharge, included higher SBP at admission between 120 and 180 mmHg, a SBP plasma total cholesterol levels, a lower CI score, and pretreatment with ACE-inhibitors, calcium channel blockers and anti-platelets.
Tuttolomondo
Antonino
A
Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, P.zza delle Cliniche, n.2, 90127 Palermo, Italy. brunotutto@unipa.it
Di Sciacca
Riccardo
R
Di Raimondo
Domenico
D
Pedone
Claudio
C
La Placa
Sergio
S
Pinto
Antonio
A
Licata
Giuseppe
G
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy* / Q000401:mortality*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016208:Databases, Factual / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D017891:Pharmacoepidemiology / Q000639:trends; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality*; D016896:Treatment Outcome
D002317:Cardiovascular Agents