title: Calcium antagonists for acute ischemic stroke.
abstract: BACKGROUND
  The sudden loss of blood supply in ischemic stroke is associated with the increase of calcium ions within neurons. Inhibiting this increase could protect neurons and hence might reduce neurological impairment, disability and handicap after stroke.
  
  
  OBJECTIVE
  To determine whether calcium antagonists reduce the risk of death or dependency after acute ischemic stroke. To investigate the influence of different drugs, dosages, routes of administration, time intervals after stroke and trial design on the risk of a primary outcome.
  
  
  METHODS
  We searched the Cochrane Stroke Group Trials Register (January 2012), MEDLINE (1950 to December 2011), EMBASE (1980 to December 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2011 issue 4) and four Chinese databases (December 2011): Chinese Biological Medicine Database (CBM-disc), China National Knowledge Infrastructure (CNKI), Chinese scientific periodical database of VIP information and Wanfang Data. We also contacted trialists and researchers.
  
  
  METHODS
  All truly randomized trials comparing a calcium antagonist with control in patients with acute ischemic stroke.
  
  
  METHODS
  Two authors assessed all trials and extracted the data. We used death or dependency at the end of long-term follow-up (at least three months) in activities of daily living as the primary outcome. Analyses were, if possible, intention-to-treat.
  
  
  RESULTS
  We included 34 trials including 7731 patients. There was no effect of calcium antagonists on the primary outcome (risk ratio (RR) 1.05; 95% confidence interval (CI) 0.98 to 1.13), or on death at the end of follow-up (RR 1.07, 95% CI 0.98 to 1.17). Comparisons of different doses of nimodipine suggested that the highest doses were associated with poorer outcome.
  
  
  CONCLUSIONS
  No evidence is available using calcium antagonists in patients with acute ischemic stroke is effective.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.forename: Canfei
authors.initials: C
authors.lastname: Zhang
authors.forename: Xiaoqun
authors.initials: X
authors.lastname: Jiang
authors.forename: Hongqing
authors.initials: H
authors.lastname: Zhou
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
mesh_terms: D002545:Brain Ischemia / Q000188:drug therapy*; D002118:Calcium / Q000378:metabolism; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000188:drug therapy*
chemical_list: D002121:Calcium Channel Blockers; D002118:Calcium