title: Efficacy of Combined Antithrombotic, Statins and Anti-Hypertensive Drugs in Acute Ischemic Stroke.
abstract: BACKGROUND
  Anti-thrombotic, statins and antihypertensive drugs are commonly used for the management of acute ischemic stroke in Nepal but there is no evidence regarding their efficacy in our context. This study aims to explore the efficacy of these combined medications (anti-thrombotic, statins and antihypertensive drugs) in acute ischemic stroke patients for the first time and to assess the risk factors present in those patients.
  
  
  METHODS
  The study was conducted on 37 acute ischemic stroke patients admitted and treated at the Neurology Department of College of Medical Sciences-Teaching Hospital, Chitwan, Nepal and they were followed at three months (90±10 days). The initial stroke severity and functional disability were evaluated at admission and at 3 months using National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) respectively. The outcome parameters were functional independence (mRS≤2) and mortality at three months (mRS=6). Frequency distribution, Mann-Whitney U-test and χ2 test were performed for statistical analysis.
  
  
  RESULTS
  Out of 37 patients, 27 (73%) were Smoker, 22 (59.5%) had hypertension and 19 (51.4%) were alcohol consumer. The stroke severity on admission was statistically significant with functional independence (P=0.003) and mortality (P=0.015) at three month. Similarly, Rankin grade on admission was statistically significant with functional independence (P=0.001) and mortality (P=0.048) at three month. At three months, 20 (69%) survived patients were independent while mortality was seen in eight (21.6%) patients.
  
  
  CONCLUSIONS
  The management of acute ischemic stroke with combined anti-thrombotic, statins and antihypertensive drugs seems promising and efficacious in mild to moderately severe ischemic stroke.
authors.affiliation: Department of Pharmacy, National Model College for Advance Learning, Kathmandu, Nepal.
authors.forename: R S
authors.initials: RS
authors.lastname: Poudel
authors.affiliation: Department of Neurology, College of Medical Sciences Teaching Hospital, Chitwan, Nepal.
authors.forename: L
authors.initials: L
authors.lastname: Thapa
authors.affiliation: Department of Pharmacy, Shree Medical and Technical College, Chitwan, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Shrestha
authors.affiliation: Department of Community Medicine, College of Medical Sciences Teaching Hospital, Chitwan, Nepal.
authors.forename: D
authors.initials: D
authors.lastname: Khatiwada
authors.affiliation: Department of Pharmacy, National Model College for Advance Learning, Kathmandu, Nepal.
authors.forename: N
authors.initials: N
authors.lastname: Upadhyay
authors.affiliation: Jutpani Primary Health Centre, Chitwan, Nepal.
authors.forename: T R
authors.initials: TR
authors.lastname: Bhandari
authors.affiliation: Khairenitar Primary Health Centre, Nuwakot, Nepal.
authors.forename: A
authors.initials: A
authors.lastname: Shrestha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009390:Nepal; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: antihypertensive; anti-thrombotic; efficacy; statins; stroke.