Calcium antagonists for acute ischemic stroke

source extracted confidence: high 2026-04-09
#brain-ischemia #calcium #calcium-channel-blockers #humans #randomized-controlled-trials-as-topic

Calcium antagonists for acute ischemic stroke

Zhang et al., 2012 | Cochrane Database Syst Rev | Meta Analysis

Citation

Zhang Jing, Yang Jie, ... Liu Ming. Calcium antagonists for acute ischemic stroke. Cochrane Database Syst Rev. 2012-May-16(5):CD001928. doi:10.1002/14651858.CD001928.pub2

Abstract

BACKGROUND: The sudden loss of blood supply in ischemic stroke is associated with the increase of calcium ions within neurons. Inhibiting this increase could protect neurons and hence might reduce neurological impairment, disability and handicap after stroke. OBJECTIVES: To determine whether calcium antagonists reduce the risk of death or dependency after acute ischemic stroke. To investigate the influence of different drugs, dosages, routes of administration, time intervals after stroke and trial design on the risk of a primary outcome. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (January 2012), MEDLINE (1950 to December 2011), EMBASE (1980 to December 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2011 issue 4) and four Chinese databases (December 2011): Chinese Biological Medicine Database (CBM-disc), China National Knowledge Infrastructure (CNKI), Chinese scientific periodical database of VIP information and Wanfang Data. We also contacted trialists and researchers. SELECTION CRITERIA: All truly randomized trials comparing a calcium antagonist with control in patients with acute ischemic stroke. DATA COLLECTION AND ANALYSIS: Two authors assessed all trials and extracted the data. We used death or dependency at the end of long-term follow-up (at least three months) in activities of daily living as the primary outcome. Analyses were, if possible, intention-to-treat. MAIN RESULTS: We included 34 trials including 7731 patients. There was no effect of calcium antagonists on the primary outcome (risk ratio (RR) 1.05; 95% confidence interval (CI) 0.98 to 1.13), or on death at the end of follow-up (RR 1.07, 95% CI 0.98 to 1.17). Comparisons of different doses of nimodipine suggested that the highest doses were associated with poorer outcome. AUTHORS' CONCLUSIONS: No evidence is available using calcium antagonists in patients with acute ischemic stroke is effective.

Key Findings

We included 34 trials including 7731 patients. There was no effect of calcium antagonists on the primary outcome (risk ratio (RR) 1.05; 95% confidence interval (CI) 0.98 to 1.13), or on death at the end of follow-up (RR 1.07, 95% CI 0.98 to 1.17). Comparisons of different doses of nimodipine suggested that the highest doses were associated with poorer outcome. AUTHORS' CONCLUSIONS: No evidence is available using calcium antagonists in patients with acute ischemic stroke is effective.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population acute ischemic stroke
Sample Size 7731
Age Range See abstract
Condition See abstract

MeSH Terms

  • Brain Ischemia
  • Calcium
  • Calcium Channel Blockers
  • Humans
  • Randomized Controlled Trials as Topic
  • Stroke

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: calcium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09