London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 299 41 Acute stroke: new treatment concepts Double-Blind, Placebo-Controlled, Clinical study to Investigate the Safety and Efficacy of NeuroAid on Motor Recovery after Ischemic Stroke H. Pakdaman1 Shahid Beheshti University of Medical Sciences, Tehran, IRAN1 Background: To date, no effective treatment has been found for reducing stroke-induced disability. NeuroAid as a Traditional Chinese Medicine has been developed to aid post-stoke recovery. Our study aim was to investigate the safety and efficacy of NeuroAid on motor recovery after ischemic stroke. Methods: In a double-blind, placebo-controlled clinical trial study on 150 patients with a recent (less than 3 month) ischemic stroke, patients were given either NeuroAid (100 patients) or placebo (50 patients), 4 capsules 3 times a day, as an add-on to standard medication of post stroke for 3 months. The patients have visited at the beginning and every 10 days in the first months and every two weeks in the second and third month. The efficacy endpoint was improvement of impairment of the affects upper and lower limbs as assessed on the Fugl-Meyer Assessment (FMA). Patients were categorized into 3 subgroups according to their baseline FMA score at initiation of the clinical trial: severe (0- 55), moderate (56-80) and mild (81-100). Results: Baseline characteristics for gender, age and elapsed time from stroke onset and risk factors were not significantly different between two groups (p>0.05). There were no difference in FMA score at baseline; 53.69±23.01 in the NeuroAid and 54.96±24.27 in the control group, p=0.755. FMA scores increases significantly in NeuroAid comparing to controls in 4th week (77.13±19.22 vs. 63.50±24.21;p<0.001), 8th week (82.51±14.27 vs. 72.06±21.41; p=0.001) and 12th week (86.22±12.34 vs. 82.78±14.93;p<0.001) after medication. Repeated measured analysis showed sta-tistically difference in FMA during 12 months between two groups (p<0.001). Patients showed a good tolerability to treatment and adverse events were mild and transient. Conclusion: NeuroAid showed better motor recovery than placebo and was safe on top of standard ischemic stroke medication. It was more effective in motor recovery in subjects with severe and moderate than mild patients. 42 Acute stroke: new treatment concepts Statin pretreatment reduces the risk of early recurrent stroke in patients with large-artery atherosclerotic infarction G. Tsivgoulis1, I. Heliopoulos2, K. Vadikolias3, D. Athanasiadis4, M. Flamouridou5, A. Andrikopou-lou6, A. Mitsoglou7, P. Dalos8, C. Arvaniti9, G.S. Georgiadis10, M.K. Lazarides11, S.N. Vasdekis12, K. Voumvourakis13, L. Stefanis14, C. Piperidou15 Department of Neurology, Democritus University of Thrace,, Alexandroupolis, GREECE1, De-partment of Neurology, Democritus University of Thrace,, Alexandroupolis, GREECE2, Department of Neurology, Democritus University of Thrace,, Alexandroupolis, GREECE3, Vascular Unit, Third Department of Surgery, School of Medicine, University of Athens School, Athens, GREECE4, De-partment of Neurology, Democritus University of Thrace, Alexandroupolis, GREECE5, Second De-partment of Neurology, School of Medicine, University of Athens School,, Athens, GREECE6, De-partment of Neurology, Democritus University of Thrace, Alexandroupolis, GREECE7, Department of Neurology, Democritus University of Thrace, Alexandroupolis, GREECE8, Second Department of Neurology, School of Medicine, University of Athens School,, Athens, GREECE9, Department of Vascular Surgery, Democritus University of Thrace, Alexandroupolis, GREECE10, Department of Vascular Surgery, Democritus University of Thrace, Alexandroupolis, GREECE11, Vascular Unit, Third Department of Surgery, School of Medicine, University of Athens School, Athens, GREECE12, Second Department of Neurology, School of Medicine, University of Athens School,, Athens, GREECE13, Second Department of Neurology, School of Medicine, University of Athens School,, Athens, GREECE14, Department of Neurology, Democritus University of Thrace, Alexandroupolis, GREECE15 Background&Purpose: Large-artery atherosclerotic stroke (LAA) has a substantially higher risk of early recurrent stroke in comparison to other acute ischemic stroke (AIS) subtypes. Observation-al data indicate that pretreatment with statins appear to improve acute stroke outcomes including mortality and early neurological deterioration. We sought to investigate whether pretreatment with statins was associated with a low risk of early recurrent stroke in patients with AIS due to LAA. Subjects&Methods: Consecutive patients with acute LAA were evaluated at two tertiary care stroke centers over a 4 year period. Demographic characteristics, vascular risk factors and secondary pre-vention therapies were documented. Stroke severity at hospital admission was assessed using the NIHSS-score. The outcome of interest was recurrent stroke during 30-day follow-up. Recurrent stroke were classified according to TOAST criteria. Statistical analyses were performed using the Kaplan-Meier product-limit method and multivariate logistic regression models. Results: A total of 209 patients with acute cerebral ischemia due to LAA (mean age 65±14 years, 58% men, median admission NIHSS-score 7 points, interquartile range 4-10) were evaluated. Pre-treatment with statins was identified in 83 (40%) individuals. The cumulative 30-day recurrence rate was lower in patients with statin pretreatment (2.2%; 95%CI:0.0-5.5) compared to the rest (11.2%; 95%CI:5.7%-16.7%; p=0.019). On multivariate logistic regression models adjusting for potential confounders pretreatment with statins was associated with a lower likelihood of 30-day recurrent stroke (OR: 0.11, 95%CI: 0.02-0.52; p=0.006), while diabetes mellitus (OR: 5.59, 95%CI: 1.82- 17.19; p=0.003) and coronary artery disease (OR: 3.29, 95%CI: 1.00-10.79; p=0.049) were related to higher odds of 30-day recurrent stroke. Conclusions: Our pilot data indicate that in acute patients with LAA infarction statin pre-treatment was associated with reduced early risk of recurrent stroke. These findings support the hypothesis that treatment statins in the acute setting of cerebral ischemia may prove beneficial.
Karger_ESC London_2013
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