Pre-stroke use of antihypertensives, antiplatelets, or statins and early ischemic stroke outcomes.

BACKGROUND

The effect of pre-stroke use of antihypertensives, antiplatelets, and statins on initial severity and early outcome of ischemic stroke is uncertain.

METHODS

We performed a retrospective chart review of 553 consecutive acute ischemic stroke patients presenting to the Montreal General Hospital between April 1st 2002 and October 15th 2005. We defined a severe stroke as a Canadian Neurological Scale score of < or =7 and a poor early outcome as a modified Rankin Scale score of >3 at 10 days post-stroke.

RESULTS

In total, 339 patients were included. Superior early functional outcome was associated with the premorbid use of statins (OR = 0.50, 95% CI: 0.25-1.00) and the combination of all 3 medications (OR = 0.37, 95% CI: 0.16-0.87). Angiotensin-II-decreasing agents were associated with an increased risk of severe strokes (OR = 2.13, 95% CI: 1.00-4.52).

CONCLUSIONS

Pre-stroke use of statins and the combination of antihypertensives, antiplatelets, and statins were both associated with a favorable functional outcome at 10 days post-stroke. Angiotensin-II-decreasing agents were associated with increased initial stroke severity.