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From the Department of Pharmacology, EA 1046 (D.D., I.M., C. Lefebvre, C. Libersa, R.B.); Clinical Investigation Center, CIC 9301 INSERM-CHU (D.D., I.M., C. Libersa); Department of Neurology and Stroke Unit, EA 2691 (C. Lefebvre, D.L.); Institut de Médecine Prédictive et de Recherche Thérapeutique, University Hospital of Lille and University of Lille 2, France.
Address correspondence and reprints requests to Pr. R. Bordet, Department of Pharmacology, EA 1046, Faculty of Medicine, F-59045 Lille, France; e-mail: r-bordet{at}chru-lille.fr
Objective: To determine clinical and pharmacologic factors that could influence the initial severity and short-term outcome of cerebral ischemia.
Methods: In a cross-sectional hospital-based study of patients with acute supratentorial ischemic stroke, we systematically collected medical history, previous leisure-time physical activity, current and previous treatments, blood pressure, temperature, blood glucose, fibrinogen, NIH Stroke Scale (NIHSS) score at admission, and outcome at day 8. Factors potentially associated with initial stroke severity and outcome were selected by univariate analyses and then validated in logistic regression analyses with lower severity of stroke at admission (NIHSS 0 to 5) or good outcome at day 8 (modified Rankin Scale 0 to 1, Barthel Index 95 to 100) as dependent variables.
Results: In 362 consecutive patients (median age 70 years, range 16 to 97 years; 195 women), independent factors associated with a lower severity at admission were previous leisure-time physical activity (adjusted odds ratio [OR] 1.67, 95% CI 1.07 to 2.66), TIA (adjusted OR 2.28, 95% CI 1.06 to 4.87) and treatment with lipid-lowering drug (adjusted OR 1.76, 95% CI 1.02 to 3.03). Previous treatment with lipid-lowering drug and leisure-time physical activity were also independent factors associated with a good short-term outcome.
Conclusion: Both regular physical activity and lipid-lowering drugs should be prospectively evaluated to determine whether they reduce the severity of ischemic stroke.
This study was funded by a Programme Hospitalier de Recherche Clinique (PHRC 2001R/1921) and by the research groups on "Pharmacology of neuronal death and cerebral plasticity" (EA 1046) and "Cognitive decline in degenerative and vascular disorders" (EA 2691) from the Ministère Français de l’Education Nationale, de la Recherche et de la Technologie.
Disclosure: The Department of Pharmacology (D. Deplanque, I. Masse, C. Lefebvre, C. Libersa, R. Bordet) has received a research grant from GENFIT S.A. to explore neuroprotective effects of PPAR activators and statins in animal models of ischemic stroke. D. Leys has nothing to disclose.
Received February 7, 2006. Accepted in final form June 13, 2006.
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