Stroke: prostacyclin had no clear effect on death.

Clinical bottom line (level 1a-)

  1. Patients with acute ischaemic stroke who were given prostacyclin or its analogues had no clear difference in early death, than those given placebo.
Bath and Bath: The Cochrane Library, Issue 2, Oxford: Update Software 1999; 2: -
Expires December 2002

The study

Systematic review of randomised controlled parallel group trials of
  • Patients: acute stroke
  • Intervention: intravenous prostacyclin or analogues within one week of stroke compared with placebo
  • Outcome: death within one month


    • Articles found in ?language using Cochrane Stroke Group trilas register, MEDLINE, EMBASE, ISI, from 1965 (search terms: stroke or cerebr* and prostacyclin or epoprostenol or ciprostene or clioprost or iloprost or isocarbacyclin or beraprost or TPK-100 or ONO-41483 or HOE 892 or OP-2507 or 2K-36374 ) and contacted drug companies and principal investigators of included trials.

    Selection criteria: as above
    Appraisal criteria: detailed
    Articles excluded if: not acute stroke

    Five trials involving 191 patients were included.
    There was no statistical heterogeneity.

    The evidence

    Outcome Time to outcome RRR
    (95% CI)
    Early death 1 months 37.0%
    (-85.0% to 78.0%)

    Comments

    1. The reviewers concluded that there was insufficient evidence to evaluate these drugs as treatment for people with acute ischaemic stroke
    2. Late mortality and functional outcomes were insufficiently studied in the trials

    Citation

    1. Bath P, and Bath F: Prostacyclin and analogues for acute ischaemic stroke. The Cochrane Library, Issue 2, Oxford: Update Software 1999; 2: -
    Contributor: Clare Wotton and Musab Hayatli, December 1999
    Reviewer: RH Harwood

    Clinical Question.
    Patient acute stroke
    Intervention or Exposure prostacyclin or analogue
    Comparison placebo
    Outcome early death