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Treatment with angiotensin-converting enzyme inhibitors is associated with a reduction in short-term mortality in older patients with acute ischemic stroke
- Source :
- Scopus-Elsevier
- Publication Year :
- 2005
-
Abstract
- Background Stroke is the third cause of death in older people living in Western countries. We tested the hypothesis that angiotensin-converting enzyme inhibitors (A-I) might affect short-term (30 day) mortality in older persons with severe acute ischemic stroke. Methods We analyzed data from a retrospective study including 475 consecutive older patients hospitalized for acute ischemic stroke. Mean age was 78.4 +/- 9.2 years; 58.2% were female. Stroke type was classified according to the Oxford Community Stroke Project (OCSP). Results Mortality rate was 28%. Thirty-two percent of patients were treated with A-I; mortality was 16.5% in patients treated compared with 33.3% in those not treated (chi(2) p =.001). The odds ratio for mortality in treated patients was: 0.47 (0.25-0.89) after full adjustment (age, sex, mean diastolic and systolic blood pressure, previous stroke and/or transient ischemic attack, congestive heart failure, atrial fibrillation, diabetes, hypertension, coronary heart disease, and previous treatment with A-I); 0.29 (0.09-0.89) in patients with altered level of consciousness after full adjustment; 0.60 (0.33-1.12) after adjustment for OCSP classification, age, and sex; and 0.30 (0.08-0.97) in total anterior circulation infarction stroke type after full adjustment. Conclusions Our data suggest that treatment with A-I might reduce short-term mortality in older patients with acute ischemic stroke. Randomized clinical trials should confirm this possible specific effect of A-I.
- Subjects :
- Male
Aging
medicine.medical_specialty
Consciousness
ACE-INHIBITORS
Angiotensin-Converting Enzyme Inhibitors
Coronary Disease
Brain Ischemia
Brain ischemia
Diabetes Complications
Infarction, Posterior Cerebral Artery
Sex Factors
Internal medicine
Cause of Death
Atrial Fibrillation
medicine
Humans
Stroke
Infarction, Anterior Cerebral Artery
Cause of death
Aged
Retrospective Studies
Heart Failure
Cerebral infarction
business.industry
MORTALITY
Mortality rate
Age Factors
ISCHEMIC STROKE
Atrial fibrillation
Cerebral Infarction
medicine.disease
Survival Rate
Blood pressure
Heart failure
Hypertension
Cardiology
Physical therapy
Female
Geriatrics and Gerontology
business
Subjects
Details
- ISSN :
- 10795006
- Volume :
- 60
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The journals of gerontology. Series A, Biological sciences and medical sciences
- Accession number :
- edsair.doi.dedup.....31c693859d486a0d51508f6d8ccbdb56