6533b7d8fe1ef96bd126a46d

RESEARCH PRODUCT

Effects of clinical and laboratory variables at admission and of in-hospital treatment with cardiovascular drugs on short term prognosis of ischemic stroke. The GIFA study.

Valentina ArnaoAntonino TuttolomondoAntonio PintoR. Di SciaccaS La PlacaDomenico Di RaimondoG. LicataClaudio Pedone

subject

Malemedicine.medical_specialtyTime FactorsEndocrinology Diabetes and MetabolismHypercholesterolemiaMedicine (miscellaneous)Angiotensin II Receptor BlockersCharlson indexAngiotensin-Converting Enzyme InhibitorsComorbidityBrain IschemiaInternal medicineActivities of Daily LivingmedicineHumansIn patientcardiovascular diseasesStrokeGeriatric AssessmentAgedRetrospective StudiesNutrition and Dieteticsbusiness.industryCardiovascular AgentsHeparinmedicine.diseaseCalcium Channel BlockersPrognosisStrokeHospital treatmentItalyIschemic strokeHypertensionPhysical therapyFunctional statusFemaleCardiology and Cardiovascular MedicinebusinessCognition DisordersPlatelet Aggregation Inhibitorsmedicine.drug

description

Abstract Introduction No information exists, to our knowledge, about the possible role of cardiovascular drug administration in the acute phase of ischemic stroke and possible effects on stroke outcome. The aim of our study was to evaluate the relationship between in-hospital treatment with cardiovascular drugs in patients with acute ischemic stroke and some outcome indicators. Methods and Results 1096 subjects enrolled in the GIFA study, who had a main discharge diagnosis of ischemic stroke represent the final sample. Drugs considered for the analysis were the following: ACE-inhibitors (ACEI), angiotensin II receptor blockers (ARBs), statins, calcium-channel-blockers (CCBs), antiplatelet (APL) drugs, antivitamin-k (VKAs), and heparins. As outcome indicators we choose in-hospital mortality, cognitive function evaluated by Hodkinson Abbreviated Mental Test (HAMT), and functional status evaluated by activity daily living (ADL). Indicators of a good outcome were: no in-hospital mortality, HAMT >6 and 0 ADL impaired. Patients with a good outcome showed a higher rate of in-hospital treatment with ACE-inhibitors, calcium-channel blockers and a lower rate of pre-treatment with heparin. Conclusions Our study suggests that if a patient with acute ischemic stroke has higher SBP at admission, higher total cholesterol plasma levels, a lower Charlson index and is treated with ACE-inhibitors, calcium channel blockers and antiplatelet drugs, the short term outcome is better in terms of in-hospital mortality and functional indicators such as cognitive and functional performance at discharge.

10.1016/j.numecd.2012.01.010https://pubmed.ncbi.nlm.nih.gov/22502765