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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Published on: January 18, 2018

Calcium antagonists for acute ischemic stroke.

Jing Zhang1, Jie Yang, Canfei Zhang

  • 1Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.

The Cochrane Database of Systematic Reviews
|May 18, 2012
PubMed
Summary

Calcium antagonists do not reduce the risk of death or dependency in acute ischemic stroke patients. Higher doses of nimodipine were linked to worse outcomes, indicating a lack of therapeutic benefit.

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Area of Science:

  • Neurology
  • Pharmacology
  • Clinical Trials

Background:

  • Ischemic stroke involves a sudden loss of blood supply, leading to increased intracellular calcium ions in neurons.
  • Elevated calcium levels can cause neuronal damage, potentially resulting in long-term neurological impairment, disability, and handicap.
  • Inhibiting calcium influx is a potential neuroprotective strategy for stroke patients.

Purpose of the Study:

  • To evaluate the efficacy of calcium antagonists in reducing death or dependency following acute ischemic stroke.
  • To analyze the impact of drug type, dosage, administration route, timing, and trial design on stroke outcomes.

Main Methods:

  • Systematic review and meta-analysis of 34 randomized controlled trials (RCTs) involving 7731 patients.
  • Searched multiple databases including MEDLINE, EMBASE, Cochrane Library, and Chinese databases up to December 2011.
  • Primary outcome: death or dependency in activities of daily living at least three months post-stroke; intention-to-treat analysis used where possible.

Main Results:

  • Calcium antagonists showed no significant effect on the primary outcome of death or dependency (Risk Ratio [RR] 1.05; 95% Confidence Interval [CI] 0.98 to 1.13).
  • No significant reduction in death at follow-up was observed (RR 1.07, 95% CI 0.98 to 1.17).
  • Analysis of nimodipine indicated that higher doses were associated with poorer patient outcomes.

Conclusions:

  • Current evidence does not support the use of calcium antagonists for treating acute ischemic stroke.
  • The findings suggest a potential harm associated with higher doses of certain calcium antagonists, like nimodipine.