Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
The efficacy and safety of nimodipine in acute ischemic stroke patients with mild cognitive impairment: a double-blind, randomized,placebo-controlled trial
First author：Huaguang Zheng, Yilong Wang
Corresponding author：Yongjun Wang
essential_information
- Person in charge：Huaguang Zheng, Yilong Wang
- Data Sources： NICE
- Number of papers：OTHERS20190776
- Published time：2019-01-30
2019-01-30
Published articles
Background And Purpose
Method
In this multicenter, double-blind trial, we randomly assigned 654 eligible patients to nimodipine 30 mg three times a day or placebo. The primary outcome was any cognitive decline defined by the changes on the Mini-Mental State Examination (ΔMMSE ≤ −3) or vascular AD assessment scale cognitive subscale (ΔADAS-cog ≥ 4) at 6 months. Secondary outcomes included any distribution shift of ΔADAS-cog, ΔMMSE or cognitive improvement defined by ΔADAS-cog ≤ −2, or ΔMMSE ≥ 0.
Conclusion
Nimodipine was associated with better cognitive function in the memory domain. The adverse events rate was similar in two groups. This study is registered with ClinicalTrials.gov, NCT01220622. Nimodipine did not show benefit to prevent cognitive decline in AIS patients with VaMCI, but improved cognition moderately, especially measured in the memory domain.
Main results
The primary outcome in the nimodipine group and placebo group were similar for ΔMMSE ≤ −3 (4.18% and 7.22%, respectively, P = 0.15) and ΔADAS-cog ≥ 4 (8.36% and 8.93% respectively, P = 0.88). The distribution shift of ΔADAS-cog and ΔMMSE differed significantly between the two groups (P = 0.03 and P = 0.05 respectively). Cognitive improvement occurred in 55.4% in the nimodipine group and 43.6% in the placebo group measured by ΔADAS-cog ≤ −2 (Odds Ratio, 1.54; 95% confidence interval [CI] 1.10–2.14, P < 0.01) or 84.0% and 74.6% respectively by ΔMMSE ≥ 0 (Odds Ratio, 1.79; 95% CI 1.18–2.70, P < 0.01).