Prestroke use of ACEI combined with antiplatelets and/or statins did not significantly differ from ACEI alone in improving functional outcome at discharge after ischemic stroke (P=0.852).
Observational (n=505)
No
Does prestroke combination therapy of ACE inhibitors with antiplatelets and/or statins improve functional outcome at discharge compared to ACE inhibitors alone in ischemic stroke patients?
Prestroke use of ACE inhibitors is associated with better functional outcomes after ischemic stroke, but adding antiplatelets or statins does not provide significant additive functional benefit over ACE inhibitors alone.
p-value: p=0.852
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs), antiplatelets (APs), and statin are increasingly being prescribed for ischemic stroke prevention. OBJECTIVES: The objective of the study was to examine whether previous combination therapy of ACEI with AP and/or statin has additive effect compared with ACEI alone on functional outcome after ischemic stroke. Furthermore, factors associated with improving functional outcome were investigated. METHODS: Ischemic stroke patients attending a Malaysian hospital in 2008 were categorized according to Barthel Index at discharge. Favorable outcome was defined as Barthel Index of 75 or greater. Data included demographic information, clinical characteristics, and previous medications with particular attention to ACEI, AP, and statin. RESULTS: Overall, 505 patients were included. Variables associated with good functional outcome were younger age (P = 0.002), first-ever attack (P = 0.016), lacunar (P = 0.015) or posterior circulation infarct stroke subtype (P = 0.034), minor Glasgow Coma Scale (P < 0.001), and previous use of ACEI alone or combined with AP and/or statin (P = 0.002). Using ACEI alone as the reference for ACEI + AP, ACEI + statin, or ACEI + AP + statin combinations, there was no significant difference among combinations on improving functional outcome (P = 0.852). CONCLUSIONS: Prestroke use of ACEI either alone or combined with AP and/or statin was associated with better functional outcome. Previous use of ACEI in combination with AP and/or statin did not significantly differ from ACEI alone in their effect on outcome. Our study provides a potential rationale for optimizing the use of ACEI among individuals at risk of developing ischemic stroke.
Hassan et al. (Thu,) conducted a observational in Ischemic stroke (n=505). Prestroke use of ACEI combined with antiplatelets and/or statin vs. ACEI alone was evaluated on Favorable functional outcome (Barthel Index ≥ 75 at discharge) (p=0.852). Prestroke use of ACEI combined with antiplatelets and/or statins did not significantly differ from ACEI alone in improving functional outcome at discharge after ischemic stroke (P=0.852).