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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Calcium antagonists for acute ischemic stroke
1Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Beijing, Beijing, China, 100053.
The Cochrane Database of Systematic Reviews
|February 14, 2019
Summary
Calcium antagonists do not reduce death or dependency after acute ischemic stroke. This review found no evidence to support their use in stroke patients, despite potential neuroprotective mechanisms.
Area of Science:
- Neurology
- Clinical Trials
- Pharmacology
Background:
- Ischemic stroke involves increased intracellular calcium in neurons.
- Inhibiting calcium influx may offer neuroprotection and reduce stroke-related disability.
- Calcium antagonists are a class of drugs that block calcium channels.
Purpose of the Study:
- To evaluate the efficacy of calcium antagonists in reducing death or dependency post-acute ischemic stroke.
- To analyze the impact of drug type, dosage, administration, timing, and trial design on outcomes.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searched multiple databases including Cochrane, MEDLINE, Embase, and Chinese databases up to February 2018.
- Included 34 trials with 7731 participants, assessing death or dependency as the primary outcome.
Main Results:
- Calcium antagonists showed no significant effect on the primary outcome of death or dependency (RR 1.05, 95% CI 0.98 to 1.13).
- No significant difference in mortality was observed between calcium antagonist and control groups (RR 1.07, 95% CI 0.98 to 1.17).
- Adverse events did not differ significantly; however, many trials had high risk of bias due to poor reporting.
Conclusions:
- Current evidence does not support the use of calcium antagonists for treating acute ischemic stroke.
- Further high-quality trials are needed to clarify the role, if any, of calcium antagonists in stroke management.
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