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Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery.
CONCLUSIONS: We found no reliable evidence that SSRIs should be used routinely to promote recovery after stroke. Meta-analysis of the trials at low risk of bias indicate that SSRIs do not improve recovery from stroke. We identified potential improvements in disability only in the analyses which included trials at high risk of bias. A further meta-analysis of large ongoing trials will be required to determine the generalisability of these findings. PMID: 31769878 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - November 25, 2019 Category: General Medicine Authors: Legg LA, Tilney R, Hsieh CF, Wu S, Lundström E, Rudberg AS, Kutlubaev MA, Dennis M, Soleimani B, Barugh A, Hackett ML, Hankey GJ, Mead GE Tags: Cochrane Database Syst Rev Source Type: research

Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack.
CONCLUSIONS: Peroxisome proliferator-activated receptor gamma agonists probably reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and may improve insulin sensitivity and the stabilisation of carotid plaques. Their effects on adverse events are uncertain. Our conclusions should be interpreted with caution considering the small number and the quality of the included studies. Further well-designed, double-blind RCTs with large samples are required to assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular...
Source: Cochrane Database of Systematic Reviews - October 8, 2019 Category: General Medicine Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Marine-derived n-3 fatty acids therapy for stroke.
CONCLUSIONS: We are very uncertain of the effect of marine-derived n-3 PUFAs therapy on functional outcomes and dependence after stroke as there is insufficient high-quality evidence. More well-designed RCTs are needed, specifically in acute stroke, to determine the efficacy and safety of the intervention.Studies assessing functionality might consider starting the intervention as early as possible after the event, as well as using standardised clinically-relevant measures for functional outcomes, such as the modified Rankin Scale. Optimal doses remain to be determined; delivery forms (type of lipid carriers) and mode of ad...
Source: Cochrane Database of Systematic Reviews - June 25, 2019 Category: General Medicine Authors: Alvarez Campano CG, Macleod MJ, Aucott L, Thies F Tags: Cochrane Database Syst Rev Source Type: research

Stem cell transplantation for ischemic stroke.
CONCLUSIONS: Overall, in participants with ischemic stroke, stem cell transplantation was associated with a reduced neurological impairment, but not with a better functional outcome. No obvious safety concerns were raised. However, these conclusions came mostly from small RCTs with high risk of bias, and the certainty of the evidence ranged from low to very low. More well-designed trials are needed. PMID: 31055832 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 4, 2019 Category: General Medicine Authors: Boncoraglio GB, Ranieri M, Bersano A, Parati EA, Del Giovane C Tags: Cochrane Database Syst Rev Source Type: research

Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack.
CONCLUSIONS: In the field, CPSS had consistently the highest sensitivity and, therefore, should be preferred to other scales. Further evidence is needed to determine its absolute accuracy and whether alternatives scales, such as MASS and ROSIER, which might have comparable sensitivity but higher specificity, should be used instead, to achieve better overall accuracy. In the ER, ROSIER should be the test of choice, as it was evaluated in more studies than FAST and showed consistently high sensitivity. In a cohort of 100 people of whom 62 have stroke/TIA, the test will miss on average seven people with stroke/TIA (ranging fr...
Source: Cochrane Database of Systematic Reviews - April 8, 2019 Category: General Medicine Authors: Zhelev Z, Walker G, Henschke N, Fridhandler J, Yip S Tags: Cochrane Database Syst Rev Source Type: research

Calcium antagonists for acute ischemic stroke.
CONCLUSIONS: We found no evidence to support the use of calcium antagonists in people with acute ischemic stroke. PMID: 30758052 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - February 13, 2019 Category: General Medicine Authors: Zhang J, Liu J, Li D, Zhang C, Liu M Tags: Cochrane Database Syst Rev Source Type: research

General health checks in adults for reducing morbidity and mortality from disease.
CONCLUSIONS: General health checks are unlikely to be beneficial. PMID: 30699470 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - January 31, 2019 Category: General Medicine Authors: Krogsbøll LT, Jørgensen KJ, Gøtzsche PC Tags: Cochrane Database Syst Rev Source Type: research

Traditional Chinese herbal medicine for vascular dementia.
CONCLUSIONS: We found moderate- to very low-quality evidence of benefit and harm of TCHMs for VaD. Methodological inadequacies need to be addressed by better conducted and reported trials. We identified NaoMaiTai, NaoXinTong and TongXinLuo as warranting special research priority. PMID: 30520514 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 6, 2018 Category: General Medicine Authors: Chan ES, Bautista DT, Zhu Y, You Y, Long JT, Li W, Chen C Tags: Cochrane Database Syst Rev Source Type: research

Gamma aminobutyric acid (GABA) receptor agonists for acute stroke.
CONCLUSIONS: This review provides moderate-quality evidence that fails to support the use of GABA receptor agonists (chlormethiazole or diazepam) for the treatment of people with acute stroke. More well-designed RCTs with large samples of participants with total anterior circulation syndrome are required to determine if there are benefits for this subgroup. Somnolence and rhinitis are frequent adverse events related to chlormethiazole. PMID: 30376593 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - October 30, 2018 Category: General Medicine Authors: Liu J, Zhang J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Percutaneous vascular interventions versus intravenous thrombolytic treatment for acute ischaemic stroke.
CONCLUSIONS: The present review directly compared intravenous thrombolytic treatment with percutaneous vascular interventions for ischaemic stroke. We found no evidence from RCTs that percutaneous vascular interventions are superior to intravenous thrombolytic treatment with respect to functional outcome. Quality of evidence was low (outcome assessment was blinded, but not the treating physician or participants). New trials with adequate sample sizes are warranted because of the rapid development of new techniques and devices for such interventions. PMID: 30365156 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - October 26, 2018 Category: General Medicine Authors: Lindekleiv H, Berge E, Bruins Slot KM, Wardlaw JM Tags: Cochrane Database Syst Rev Source Type: research

Recanalisation therapies for wake-up stroke.
CONCLUSIONS: There is insufficient evidence from randomised controlled trials for recommendations concerning recanalisation therapies for wake-up stroke. Results from ongoing trials will hopefully establish the efficacy and safety of such therapies. PMID: 30129656 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 21, 2018 Category: General Medicine Authors: Roaldsen MB, Lindekleiv H, Mathiesen EB, Berge E Tags: Cochrane Database Syst Rev Source Type: research

Blood pressure-lowering treatment for preventing recurrent stroke, major vascular events, and dementia in patients with a history of stroke or transient ischaemic attack.
CONCLUSIONS: Our results support the use of BPLDs in people with stroke or TIA for reducing the risk of recurrent stroke. Current evidence is primarily derived from trials studying an ACE inhibitor or a diuretic. No definite conclusions can be drawn from current evidence regarding an optimal systolic blood pressure target after stroke or TIA. PMID: 30024023 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 19, 2018 Category: General Medicine Authors: Zonneveld TP, Richard E, Vergouwen MD, Nederkoorn PJ, de Haan R, Roos YB, Kruyt ND Tags: Cochrane Database Syst Rev Source Type: research

Continuation versus discontinuation of antiplatelet therapy for bleeding and ischaemic events in adults undergoing non-cardiac surgery.
CONCLUSIONS: We found low-certainty evidence that either continuation or discontinuation of antiplatelet therapy before non-cardiac surgery may make little or no difference to mortality, bleeding requiring surgical intervention, or ischaemic events. We found moderate-certainty evidence that either continuation or discontinuation of antiplatelet therapy before non-cardiac surgery probably makes little or no difference to bleeding requiring transfusion. Evidence was limited to few studies with few participants, and with few events. The three ongoing studies may alter the conclusions of the review once published and assessed....
Source: Cochrane Database of Systematic Reviews - July 18, 2018 Category: General Medicine Authors: Lewis SR, Pritchard MW, Schofield-Robinson OJ, Alderson P, Smith AF Tags: Cochrane Database Syst Rev Source Type: research

Antiplatelet and anticoagulant agents for primary prevention of thrombosis in individuals with antiphospholipid antibodies.
CONCLUSIONS: There is insufficient evidence to demonstrate benefit or harm of using anticoagulants with or without ASA versus ASA alone in people with aPL antibodies and a history of recurrent pregnancy loss and with no such history; ASA versus placebo in people with aPL antibodies; and ASA with LMWH versus placebo or IVIG, and ASA with high-dose LMWH versus ASA with low-dose LMWH or UFH, in women with aPL antibodies and a history of recurrent pregnancy loss, for the primary prevention of thrombotic events. In a mixed population of people with a history of previous pregnancy loss and without such a history treated with ant...
Source: Cochrane Database of Systematic Reviews - July 13, 2018 Category: General Medicine Authors: Bala MM, Paszek E, Lesniak W, Wloch-Kopec D, Jasinska K, Undas A Tags: Cochrane Database Syst Rev Source Type: research

Remote ischaemic conditioning for preventing and treating ischaemic stroke.
CONCLUSIONS: We found low-quality evidence that RIC may reduce the risk of recurrent stroke in participants with intracerebral artery stenosis and reduce stroke severity in participants undergoing carotid stenting, but it may increase death or dependence in participants with acute ischaemic stroke who are undergoing intravenous thrombolysis. However, there is considerable uncertainty about these conclusions because of the small number of studies and low quality of the evidence. PMID: 29974450 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 5, 2018 Category: General Medicine Authors: Zhao W, Zhang J, Sadowsky MG, Meng R, Ding Y, Ji X Tags: Cochrane Database Syst Rev Source Type: research

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