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Effects of clinical and laboratory variables and of pretreatment with cardiovascular drugs in acute ischaemic stroke: a retrospective chart review from the GIFA study.

AbstractBACKGROUND:
Few studies have examined the role of cardiovascular drugs on acute ischaemic stroke prognosis.
AIMS:
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.
AuthorsAntonino Tuttolomondo, Riccardo Di Sciacca, Domenico Di Raimondo, Claudio Pedone, Sergio La Placa, Antonio Pinto, Giuseppe Licata
JournalInternational journal of cardiology (Int J Cardiol) Vol. 151 Issue 3 Pg. 318-22 (Sep 15 2011) ISSN: 1874-1754 [Electronic] Netherlands
PMID20598761 (Publication Type: Comparative Study, Journal Article, Multicenter Study)
CopyrightCopyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Chemical References
  • Cardiovascular Agents
Topics
  • Aged
  • Aged, 80 and over
  • Brain Ischemia (drug therapy, mortality)
  • Cardiovascular Agents (administration & dosage)
  • Databases, Factual (trends)
  • Female
  • Follow-Up Studies
  • Hospital Mortality (trends)
  • Humans
  • Italy (epidemiology)
  • Male
  • Pharmacoepidemiology (trends)
  • Retrospective Studies
  • Stroke (drug therapy, mortality)
  • Treatment Outcome

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