Stroke: no benefit from calcium-channel blockers

Clinical bottom line (level 1a)

  1. Patients with a recent ischaemic stroke who receive a calcium-channel blocker compared with placebo are not clearly less likely to die or become dependent.
Horn and Limburg: Stroke 2001; 32 : 570-576
Expires December 2003

The study

Systematic review of all randomised controlled trials of
  • Patients: with a stroke within previous 14 days
  • Intervention: calcium-channel blockers
  • Outcome: death or functional dependency

    Articles found in ?all languages using Cochrane Stroke group register of trials, to May 1999 (search terms: ) and by contacting company representatives and principle investigators

    Selection criteria: by 2 independent reviewers - see above and below
    Appraisal criteria: by 2 independent reviewers: based on randomisation, concealment of allocation, blinding
    Articles excluded if:
    • not true randomisation


    22 studies found involving 6877 patients usually followed for 6 months
    • Analysis were possible was by intention-to-treat.
    Studies were not found to be significantly heterogeneous

    The evidence

    Outcome Time to outcome CER OR
    (95% CI)    		 NN?
    (% CI)
    death or dependency weeks /
    (%)    		 1.04
    (0.98 to 1.09)
    weeks /
    (%)    		 1.07
    (0.98 to 1.17)

    • A separate analysis for nimodipine given within 12 hours found no effect on death or dependency.

    Citation

    1. Horn J, and Limburg M: calcium antagonists for ischemic stroke: a systematic review. Stroke 2001; 32 : 570-576
    Search Terms: from ACP Journal Club other articles noted
    Contributor: Chris Ball, December 2001
    Reviewer:

    Clinical Question.
    Patient recent ischaemic stroke
    Intervention or Exposure calcium-channel blocker
    Comparison placebo
    Outcome death or dependency
    		•