References | Time to Randomization Post-Stroke | Set-up | Sample Size | Main Findings |
---|---|---|---|---|
Hyperlipidaemia and Stroke | ||||
[2] | Within 3 days of acute stroke | Acute hospitalization | 89 | Statin withdrawal was associated with increased risk of death or dependency at 90 days. Hence, this treatment should be continued in the acute phase of ischemic stroke. |
[3] | - | Out-patient setting | 984 | In middle-aged adults with an FRS of less than 10% and evidence of sub-clinical atherosclerosis, rosuvastatin significant reduced the rate of progression of maximum CIMT over 2 years vs. placebo. |
Diabetes Mellitus and Stroke | ||||
[4] | - | Out-patient setting | 5238 | Pioglitazone was effective in secondary not in primary stroke prevention in patients with type 2 diabetes. |
[5] | Within 24 hours of an acute stroke | Acute hospitalization | 933 | Despite significant reduction in the plasma glucose concentrations and blood pressure in the GKI group, this intervention did not reduce death or disability rates. Thus maintaining euglycaemia by GKI infusion may have a very small effect in reducing death or disability, given that it could not be seen in >900 subjects studied. |
Thrombolytic and Stroke | ||||
[8] | Within 3 hours of an acute stroke | Acute hospitalization | 24 | Administration of UA appeared to be safe, decreased lipid peroxidation, and prevented an early fall of UA in serum in patients treated with rt-PA within 3 hours of stroke onset. However, no beneficial clinical effect between the 2 groups was noted. |
[10] | Within 24 hours of an acute stroke | Acute hospitalization | 120 | The NEST-1 study indicated that infrared laser therapy was a safe and effective treatment for ischemic stroke in humans when initiated within 24 hours of stroke onset. |
[11] | Within 6 hours of an acute stroke | Acute hospitalization | 114 | The primary end point did not reach statistical significance. However, the secondary analyses showed that intra-arterial thrombolysis to have the potential to increase excellent functional outcome. |
Antiplateltes and Stroke | ||||
[14] | ≤ 6-months | Out-patient setting | 1068 | This study showed that medium intensity oral anticoagulation (target INR range 2.0-3.0) was equally effective as aspirin for secondary prevention after transient ischemic attack or minor stroke of arterial origin. However, increased bleeding complications in the oral anticoagulation group offset its protective effect against ischemic events. |
[16] | - | Out-patient setting | 973 | This study suggests anticoagulation therapy benefits people aged over 75 who have atrial fibrillation, unless there are contraindications to its use or the patient decides that the hemorrhagic risk outweighs its benefit. |
Neuroprotection and Stroke | ||||
[17] | ≤ 6-hours of acute intracranial hemorrhage | Acute hospitalization | 607 | NXY-059 given within 6 hours of acute ICH was to found a good safety and tolerability profile, with no adverse effect on clinical outcomes but also no benefits. |
[19] | ≤ 6-hours of acute ischemic stroke | Acute hospitalization | 3306 | NXY-059 was ineffective for the treatment of acute ischemic stroke within 6 hours after the onset of symptoms. |
[21] | ≤ 6-hours of acute ischemic stroke | Acute hospitalization | 152 | This study despite its small sample size and open label suggests minocycline to be of potential functional benefit in acute ischemic stroke. |
Surgery for Stroke | ||||
[22] | 92 days | - | 16 | This trial failed to show a benefit of endovascular treatment for vertebral artery stenosis. The reason for lack of benefit of endovascular treatment may mainly be due to the small numbers of patients included in the study. |
[24] | ≤ 3 hours | Acute hospitalization | 10 | Endovascular stent-assisted thrombolysis was found to be a promising treatment option in tandem internal carotid and middle cerebral artery occlusion with ICA dissection and compared favorably to intravenous rtPA alone. Unfortunately, the small numbers of individuals studied in these tests of surgical interventions for stroke make confident conclusions impossible, despite the potential interest of these approaches. |
Stroke and Subarachnoid Hemorrhage (SAH) | ||||
[25] | Within 48 hours of SAH | Acute Hospitalization | 32 | Nicardipine prolonged-release implants reduced the incidence of cerebral vasospasm and delayed ischemic deficits and improved clinical outcome after severe SAH. |
[27] | Within 72 hours of SAH | Acute Hospitalization | 71 | Hydrocortisone supported hypervoluemic therapy was more effective than hypervolemic therapy alone in treating SAH induced hyponatremia only. It was unable to relieve symptomatic cerebral vasospasm. |
Depression and Stroke | ||||
[28] | 1-2 months | Outpatient setting | 188 | The Activate-Initiate-Monitor care management model was more effective than usual care in improving depression outcome measures in patients with post-stroke depression. |
[29] | Within 28 days of acute stroke | Acute hospitalization | 411 | Motivational interviewing leads to an improvement in patients' mood 3 months after stroke. |
Bone Loss and Stroke | ||||
[30] | Within 35 days of acute stroke | Hospital based | 27 | In this study a single infusion of zoledronate in patients with moderately severe strokes protected them from the harmful effects of hemiplegia on hip bone density for at least 1 year. |
Deep Vein Thrombosis and Stroke | ||||
[31] | Within 48 hours of acute ischemic stroke | 1762 | Enoxaparin was preferable to unfractionated heparin for deep venous thromboembolism prophylaxis because of its superior clinical benefit to risk ratio and convenience of once daily administration. | |
Treatment of Transient Ischemic Attack | ||||
[34] | - | Population based | 1278 | Early initiation of existing treatments (antiplatelets aspirin or clopidogrel, anticoagulant, statin, and an ACE inhibitor) after TIA or minor stroke was associated with an 80% reduction in the risk of early recurrent stroke. There was no associated increase in the risk of intracerebral hemorrhage or other bleeding. |
[35] | Within 24 hours of acute stroke | - | 392 | In patients who are at a high risk of ischemic stroke immediately after TIA or minor stroke, the potential benefit of ischemic stroke reduction from combined aspirin and clopidogrel was not offset by their hemorrhagic risk. Simvastatin did not reduce the risk of recurrent strokes in this patient population. |