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Relationship between pre-stroke cardiovascular medication use and stroke severity

  • Pharmacoepidemiology and Prescription
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Abstract

Introduction

Stroke is a major health problem with important morbidity and mortality. Various risk factors and cardiovascular medication groups are known to have an influence on stroke incidence, but less is known about the relation between medication use and stroke severity.

Aim

To determine if relationships exist between the pre-stroke cardiovascular medication use and stroke severity.

Methods

A retrospective study was conducted on a database with anonymized data of 1974 patients with a suspected stroke, admitted to the Universitair Ziekenhuis (UZ) Brussel. Stroke severity was quantified using the National Institute of Health Stroke Scale (NIHSS). Cardiovascular medication groups were first included in a multivariable linear regression model. Second, to obtain clinically interpretable results, all variables that were retained in the final linear regression model were introduced in a cumulative odds ordinal logistic regression model with proportional odds.

Results

Angiotensin II receptor blockers (ARBs), statins, and antiarrhythmics were significantly associated with stroke severity at the 10 % α level in a multivariable linear regression model, suggesting a possible effect of these medication groups on stroke severity. Only pre-stroke statin use showed a significant relationship with the NIHSS score in the ordinal logistic regression model with an adjusted odds ratio of 0.740 (95 % CI 0.580–0.944; p = 0.015).

Conclusion

Pre-stroke use of statins is significantly associated with lower stroke severity. No significant relationship was detected between pre-stroke use of other medication groups and stroke severity, defined by the NIHSS score.

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Contributions of authors

S. Desmaele contributed to the design of the study and the analysis and interpretation of the data and drafted the manuscript. P. Cornu, S. Steurbaut, and AG. Dupont contributed to the design of the study and the interpretation of the data. They all critically revised the manuscript. K. Barbé contributed to the analysis and interpretation of the data and critically revised the manuscript. R. Brouns contributed to the data acquisition and to the interpretation of the data and critically revised the manuscript. All co-authors gave final approval to submit the manuscript and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Authors and Affiliations

  1. Research Group Clinical Pharmacology and Clinical Pharmacy (KFAR), Centre for Pharmaceutical Research (CePhar), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium

    S. Desmaele, P. Cornu, S. Steurbaut & A. G. Dupont

  2. Research Group Stochastics (Stoχ), Department Mathematics (DWIS), Vrije Universiteit Brussel (VUB), Brussels, Belgium

    K. Barbé

  3. Department of Neurology, Universitair Ziekenhuis Brussel (UZB) and Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium

    R. Brouns

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  1. S. Desmaele
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  2. P. Cornu
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  3. K. Barbé
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Correspondence to S. Desmaele.

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The authors declare that they have no conflict of interest.

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This work was supported in part by an unrestricted grant by Bayer NV-SA

Additional information

S. Steurbaut and A. G. Dupont joined the last authorship: both authors contributed equally to this study.

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Desmaele, S., Cornu, P., Barbé, K. et al. Relationship between pre-stroke cardiovascular medication use and stroke severity. Eur J Clin Pharmacol 72, 495–502 (2016). https://doi.org/10.1007/s00228-015-2001-1

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  • DOI: https://doi.org/10.1007/s00228-015-2001-1

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