• Bookmark and Share Email
  • Saturday, November 24, 2012
  • Effect of Prestroke Use of Angiotensin-Converting Enzyme Inhibitors Alone Versus Combination With Antiplatelets and Statin on Ischemic Stroke Outcome
  • Published at: Clinical Neuropharmacology; DOI: 10.1097/WNF.0b013e3182348abe
    1. Yahaya Hassan
    2. Samah W. Al-Jabi
      Faculty of Pharmacy, An-Najah National University, Nablus, Palestine
    3. Noorizan A Aziz
    4. Irene Looi
    5. Sa\'ed H. Zyoud
      Poison Control and Drug Information Centre, An-Najah National University, Nablus, Palestine


    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. 

  • Bookmark and Share Email
Leave a Comment


Sa\'ed H. A. Zyoud, PhD, Assistant Professor of Clinical Pharmacy and Toxicology
Show Full ProfileEnglish CV



Please do not email me if you do not know me
Please do not e-mail me if you do not know me