Antecedent medication use and volume of ischemic stroke: a clinical and neuroimaging evaluation
Shideler, Kelsey Idina
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Stroke is the second most common cause of mortality in the world, and is the leading cause of disability in the United States. It is unclear whether cerebral infarct size is influenced by antecedent medication use in humans. The goal of this study was to investigate the possible influences of prior medication use on cerebral infarct volume in humans. We retrospectively analyzed a prospectively enrolled cohort of patients with acute ischemic stroke. Cerebral infarct volume was measured using a previously published method with high inter-rater reliability, based on a semi-automated image analysis program. We studied the association between these volumes with qualitative and quantitative data regarding medication use prior to onset of stroke symptoms. Diffusion Weighted Imaging volume was measured in 642 patients with acute ischemic stroke (mean age 64.9 years, median volume 2.5 cm3). In univariate analysis, medication use showed no effect on infarct volume, with only a slight, non-significant reduction in volume seen in patients with a history of aspirin use (OR=0.63; 95% Confidence Interval (CI) = 0.47-0.84). Based on these findings, we concluded that in patients with acute ischemic stroke, previous medication use does not appear to correlate with infarct volume.