title: Relationship between pre-stroke cardiovascular medication use and stroke severity.
abstract: BACKGROUND
  Stroke is a major health problem with important morbidity and mortality. Various risk factors and cardiovascular medication groups are known to have an influence on stroke incidence, but less is known about the relation between medication use and stroke severity.
  
  
  OBJECTIVE
  To determine if relationships exist between the pre-stroke cardiovascular medication use and stroke severity.
  
  
  METHODS
  A retrospective study was conducted on a database with anonymized data of 1974 patients with a suspected stroke, admitted to the Universitair Ziekenhuis (UZ) Brussel. Stroke severity was quantified using the National Institute of Health Stroke Scale (NIHSS). Cardiovascular medication groups were first included in a multivariable linear regression model. Second, to obtain clinically interpretable results, all variables that were retained in the final linear regression model were introduced in a cumulative odds ordinal logistic regression model with proportional odds.
  
  
  RESULTS
  Angiotensin II receptor blockers (ARBs), statins, and antiarrhythmics were significantly associated with stroke severity at the 10 % α level in a multivariable linear regression model, suggesting a possible effect of these medication groups on stroke severity. Only pre-stroke statin use showed a significant relationship with the NIHSS score in the ordinal logistic regression model with an adjusted odds ratio of 0.740 (95 % CI 0.580-0.944; p = 0.015).
  
  
  CONCLUSIONS
  Pre-stroke use of statins is significantly associated with lower stroke severity. No significant relationship was detected between pre-stroke use of other medication groups and stroke severity, defined by the NIHSS score.
authors.affiliation: Research Group Clinical Pharmacology and Clinical Pharmacy (KFAR), Centre for Pharmaceutical Research (CePhar), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium. sara.desmaele@vub.ac.be.
authors.forename: S
authors.initials: S
authors.lastname: Desmaele
authors.affiliation: Research Group Clinical Pharmacology and Clinical Pharmacy (KFAR), Centre for Pharmaceutical Research (CePhar), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Cornu
authors.affiliation: Research Group Stochastics (Stoχ), Department Mathematics (DWIS), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Barbé
authors.affiliation: Department of Neurology, Universitair Ziekenhuis Brussel (UZB) and Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Brouns
authors.affiliation: Research Group Clinical Pharmacology and Clinical Pharmacy (KFAR), Centre for Pharmaceutical Research (CePhar), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Steurbaut
authors.affiliation: Research Group Clinical Pharmacology and Clinical Pharmacy (KFAR), Centre for Pharmaceutical Research (CePhar), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium.
authors.forename: A G
authors.initials: AG
authors.lastname: Dupont
mesh_terms: D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D057911:Angiotensin Receptor Antagonists; D018927:Anti-Asthmatic Agents; D002317:Cardiovascular Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Anti-arrhythmia agents; NIHSS score; Statins; Stroke