The efficacy and safety of nimodipine in acute ischemic stroke patients with mild cognitive impairment: a double-blind, randomized,placebo-controlled trial

被引:1
|
作者
Huaguang Zheng [1 ]
Yilong Wang [1 ]
Anxin Wang [1 ]
Hao Li [2 ]
David Wang [3 ]
Xingquan Zhao [1 ]
Penglian Wang [1 ]
Haipeng Shen [4 ]
Lijun Zuo [1 ]
Yuesong Pan [1 ]
Zixiao Li [1 ]
Xia Meng [1 ]
Xianwei Wang [1 ]
Weixiong Shi [1 ]
Yi Ju [1 ]
Liping Liu [1 ]
Kehui Dong [1 ]
Chunxue Wang [1 ]
Rubo Sui [5 ]
Rong Xue [6 ]
Xiaoping Pan [7 ]
Xiaoyua Niu [8 ]
Benyan Luo [9 ]
Yi Sui [10 ]
Huali Wang [11 ]
Tao Feng [1 ]
Yongjun Wang [1 ]
机构
[1] Beijing Tiantan Hospital, Capital Medical University
[2] OSF Saint Francis Medical Center Peoria  4. Faculty of Business and Economics, University of Hong Kong  5. The First Hospital, Liao Ning Medical
[3] China National Clinical Research Center for Neurological Diseases
关键词
Nimodipine; Acute ischemic stroke; Mild cognitive impairment; Cognitive decline; Prevention;
D O I
暂无
中图分类号
R743.3 [急性脑血管疾病(中风)];
学科分类号
1002 ;
摘要
Nimodipine might be effective in subcortical vascular dementia(VaD). Its benefit in preventing further cognitive decline in patients with acute ischemic stroke(AIS) and vascular mild cognitive impairment(VaMCI) remains to be established. In this multicenter, double-blind trial, we randomly assigned 654 eligible patients to nimodipine 30 mg three times a day or placebo. The primary outcome was any cognitive decline defined by the changes on the Mini-Mental State Examination(DMMSE à3) or vascular AD assessment scale cognitive subscale(DADAS-cog ! 4) at 6 months. Secondary outcomes included any distribution shift of DADAS-cog, DMMSE or cognitive improvement defined by DADAS-cog à2, or DMMSE ! 0. The primary outcome in the nimodipine group and placebo group were similar for DMMSE à3(4.18% and 7.22%, respectively, P = 0.15) and DADAS-cog ! 4(8.36% and 8.93% respectively,P = 0.88). The distribution shift of DADAS-cog and DMMSE differed significantly between the two groups(P = 0.03 and P = 0.05 respectively). Cognitive improvement occurred in 55.4% in the nimodipine group and 43.6% in the placebo group measured by DADAS-cog à2(Odds Ratio, 1.54; 95% confidence interval[CI] 1.10–2.14, P < 0.01) or 84.0% and 74.6% respectively by DMMSE ! 0(Odds Ratio, 1.79; 95% CI 1.18–2.70, P < 0.01). Nimodipine was associated with better cognitive function in the memory domain. The adverse events rate was similar in two groups. This study is registered with ClinicalTrials.gov,NCT01220622. Nimodipine did not show benefit to prevent cognitive decline in AIS patients with VaMCI, but improved cognition moderately, especially measured in the memory domain.
引用
收藏
页码:101 / 107
页数:7
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