Piracetam for acute ischaemic stroke.
Cochrane Database Syst Rev
; (9): CD000419, 2012 Sep 12.
Article
en En
| MEDLINE
| ID: mdl-22972044
ABSTRACT
BACKGROUND:
Piracetam has neuroprotective and antithrombotic effects that may help to reduce death and disability in people with acute stroke. This is an update of a Cochrane Review first published in 1999, and previously updated in 2006 and 2009.OBJECTIVES:
To assess the effects of piracetam in acute, presumed ischaemic stroke. SEARCHMETHODS:
We searched the Cochrane Stroke Group Trials Register (last searched 15 May 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), MEDLINE (1966 to May 2011), EMBASE (1980 to May 2011), and ISI Science Citation Index (1981 to May 2011). We also contacted the manufacturer of piracetam to identify further published and unpublished studies. SELECTION CRITERIA Randomised trials comparing piracetam with control, with at least mortality reported and entry to the trial within three days of stroke onset. DATA COLLECTION ANDANALYSIS:
Two review authors extracted data and assessed trial quality and this was checked by the other two review authors. We contacted study authors for missing information. MAINRESULTS:
We included three trials involving 1002 patients, with one trial contributing 93% of the data. Participants' ages ranged from 40 to 85 years, and both sexes were equally represented. Piracetam was associated with a statistically non-significant increase in death at one month (approximately 31% increase, 95% confidence interval 81% increase to 5% reduction). This trend was no longer apparent in the large trial after correction for imbalance in stroke severity. Limited data showed no difference between the treatment and control groups for functional outcome, dependence or proportion of patients dead or dependent. Adverse effects were not reported. AUTHORS'CONCLUSIONS:
There is some suggestion (but no statistically significant result) of an unfavourable effect of piracetam on early death, but this may have been caused by baseline differences in stroke severity in the trials. There is not enough evidence to assess the effect of piracetam on dependence.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_cardiovascular_diseases
/
6_cerebrovascular_disease
Asunto principal:
Piracetam
/
Isquemia Encefálica
/
Fármacos Neuroprotectores
/
Accidente Cerebrovascular
/
Fibrinolíticos
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Cochrane Database Syst Rev
Asunto de la revista:
PESQUISA EM SERVICOS DE SAUDE
Año:
2012
Tipo del documento:
Article
País de afiliación:
Italia