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(Stroke. 2006;37:2191.)
© 2006 American Heart Association, Inc.

Cochrane Corner

Piracetam for Acute Ischemic Stroke

Graeme J. Hankey, MD, FRCP, Section Editor:; Stefano Ricci, MD; Maria Grazia Celani, MD; Teresa Anna Cantisani, MD Enrico Righetti, MD

From the UOCD Neurologia e Ictus, USL 2 dell’ Umbria, Perugia, Italy; and Neurofisiopatologia (T.A.C.), Azienda Ospedaliera, Perugia, Italy.

Correspondence to Dr S. Ricci, UOCD Neurologia e Ictus, IUSL 2, Via Cestellini, 06087 Perugia, Italy. E-mail istitaly@unipg.it

Key Words: acute ischemic stroke • piracetam

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 

Piracetam is a drug which has been marketed in several countries for many years as a "nootropic" agent (that is, a drug which has metabolic activity on human brain), and for the treatment of myoclonus. Recently, a Cochrane review has been published on efficacy of piracetam on ameliorating language in aphasic stroke patients; the drug has been reconsidered for acute stroke treatment as well.

	Objectives

 
The objective of this review was to assess the effects of piracetam in acute presumed ischemic stroke.

	Selection Criteria

 
Randomized trials comparing piracetam with control, with at least mortality reported and entry to the trial within 48 hours of stroke onset.

	Data Collection and Analysis

 
Two reviewers (S.R., M.G.C.) extracted data and assessed trial quality, and this was checked by the other 2 reviewers. Study authors were contacted for missing information.

	Main Results

 
Three trials involving 1002 people were included, with 1 trial contributing 93% of the data. Participants’ ages ranged from 40 to 85, and both sexes were equally represented. Piracetam was associated with a statistically nonsignificant increase in death at 1 month (31% increase, 95% CI 81% increase to 5% reduction; Figure). 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, dependency or proportion of patients dead or dependent. Adverse effects were not reported.

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	Discussion

 
The results of this review do not show any statistically significant effect of piracetam on early or late death. There is, however, an unfavorable . . . [Full Text of this Article]