Cerebrolysin effects on neurological outcomes and cerebral blood flow in acute ischemic stroke

Figures & data

Figure 1 Study flow chart.

Table 1 Baseline demographics and medical history of studied patients

	Total (n=43)	Cerebrolysin (n=22)	Placebo (n=21)	P-value
Age (mean ± SD)	60±9.7	60±9.6	60.1±10	0.987
Sex, no (%)
Male	22 (51.2%)	12 (54.5%)	10 (47.6%)	0.650
Female	21 (48.8%)	10 (45.5%)	11 (52.4%)
Risk factors, no (%)
Ischemic heart disease	7 (16.3%)	4 (18.2%)	3 (14.3%)	1
Diabetes mellitus	18 (41.9%)	8 (36.4%)	10 (47.6%)	0.455
Hypertension	26 (60.5%)	13 (59.1%)	13 (61.9%)	0.850
Dyslipidemia	23 (53.5%)	11 (50%)	12 (57.1%)	0.639
Smoking	6 (14%)	3 (13.6%)	3 (14.3%)	1
Drug histories, no (%)
β-blocker	9 (20.9%)	4 (18.2%)	5 (23.8%)	0.721
ACE-I	5 (11.6%)	3 (13.6%)	2 (9.5%)	1
Angiotensin receptor blocker	13 (30.2%)	8 (36.4%)	5 (23.8%)	0.510
Calcium channel blocker	1 (2.3%)	0 (0%)	1 (4.8%)	0.488
Diuretic	9 (20.9%)	3 (13.6%)	6 (28.6%)	0.281
Statin	24 (55.8%)	12 (54.5%)	12 (57.1%)	0.864
Antidiabetic	18 (41.9%)	8 (36.4%)	10 (47.6%)	0.455
Antidiabetic plus statin	10 (23.3%)	3 (13.6%)	7 (33.3%)	0.162
Antidiabetic plus antihypertensive	6 (14%)	4 (18.2%)	2 (9.5%)	0.664
Antihypertensive plus statin	9 (20.9%)	4 (18.2%)	5 (23.8%)	0.721
Stroke location, no (%)
Anterior circulation	30 (69.8%)	14 (63.6%)	16 (76.2%)	0.370
Posterior circulation	13 (30.2%)	8 (36.4%)	5 (23.8%)

Abbreviation: ACE-I, angiotensin-converting enzyme inhibitors.

Table 2 Clinical outcomes and cerebral blood flow indices measured during 90-day follow-up

	Total (n=43)	Cerebrolysin (n=22)	Placebo (n=21)	P-value
NIHSS score
Baseline	14 (13, 16)	14 (13, 15)	14 (12, 16)	0.432
Day 30	12 (10, 13)	11 (10, 12)	12 (10, 14)	0.092
Day 60	10.5 (9, 12)	10 (9, 11)	12 (10, 14)	0.008
Day 90	10 (8, 11)	9 (8, 10)	11 (10, 13.5)	0.001
Velocity of right MCA, cm/s
Baseline	48 (40, 57)	47 (39, 50)	48 (41, 64)	0.343
Day 30	49 (43, 56)	45 (38, 52)	53 (49, 57)	0.033
Day 60	50 (44, 55)	46 (42, 52)	51 (49, 57)	0.055
Day 90	50 (44, 55)	48 (41, 53)	54.5 (49, 56.5)	0.065
Velocity of left MCA, cm/s
Baseline	47 (40, 56)	49 (38, 56)	45 (40, 50)	0.806
Day 30	47 (42, 55)	46 (40, 51)	47 (43, 59)	0.768
Day 60	48.5 (41, 57)	47 (41, 52)	50 (45, 58)	0.789
Day 90	50 (43, 55)	49 (43, 52)	50 (48, 55)	0.638
Velocity of basilar artery, cm/s
Baseline	30 (21, 42)	31.5 (25, 37)	28 (18, 47)	0.504
Day 30	30 (20, 42)	31 (25, 38)	28 (20, 48)	0.610
Day 60	30 (25, 40)	30 (27, 36)	30 (20, 49)	0.341
Day 90	33 (28, 43)	32 (29, 38)	36.5 (27, 46)	0.657
Right MCA PI
Baseline	0.9 (0.8, 1.1)	0.85 (0.7, 1.1)	1 (0.8, 1.2)	0.364
Day 30	1 (0.8, 1.1)	0.85 (0.8, 1)	1.1 (0.9, 1.2)	0.010
Day 60	1 (0.8, 1.1)	0.9 (0.8, 1)	1.1 (1, 1.2)	0.001
Day 90	1 (0.9, 1.1)	0.9 (0.8, 1.1)	1 (1, 1.2)	0.014
Left MCA PI
Baseline	1 (0.8, 1.2)	1 (0.8, 1.1)	1.1 (0.8, 1.3)	0.345
Day 30	1 (0.8, 1.1)	1 (0.8, 1.1)	1.1 (0.9, 1.2)	0.286
Day 60	1 (0.9, 1.1)	1 (0.9, 1.1)	1 (0.9, 1.1)	0.627
Day 90	1 (0.9, 1.2)	1 (0.8, 1.1)	1 (0.9, 1.2)	0.277
Basilar artery PI
Baseline	1 (0.8, 1.1)	1 (0.9, 1.1)	0.9 (0.8, 1.1)	0.576
Day 30	1 (0.8, 1.1)	1 (0.8, 1.1)	0.9 (0.8, 1)	0.384
Day 60	0.95 (0.9, 1.1)	0.9 (0.9, 1.1)	1 (0.9, 1.1)	0.931
Day 90	1 (0.8, 1.1)	1 (0.9, 1.1)	0.95 (0.8, 1.1)	0.828

Abbreviations: MCA, middle cerebral artery; NIHSS, National Institutes of Health Stroke Scale; PI, pulsatility index.

Table 3 Comparison of outcomes measured during 90-day follow-up between the age subgroups among cerebrolysin-treated patients

	Age <65 (n=13)	Age ≥65 (n=9)	P-value
NIHSS score
Baseline	14 (14, 16)	14 (13, 15)	0.324
Day 30	11 (10, 12)	11 (10, 12)	0.794
Day 60	10 (9, 11)	9 (9, 10)	0.702
Day 90	9 (8, 10.5)	9 (8, 10)	0.651
Velocity of right MCA, cm/s
Baseline	44 (40, 49)	48 (39, 51)	0.845
Day 30	44 (39, 49)	48 (37, 52)	0.695
Day 60	44 (41, 50)	49 (42, 54)	0.508
Day 90	46 (40, 49.5)	50 (42, 55)	0.345
Velocity of left MCA, cm/s
Baseline	45 (40, 50)	44 (42, 59)	0.744
Day 30	42 (40, 49)	48 (45, 59)	0.126
Day 60	42.5 (39, 51)	50 (47, 60)	0.129
Day 90	44.5 (41.5, 50.5)	51 (49, 62)	0.095
Velocity of basilar artery, cm/s
Baseline	28 (21, 34)	34 (27, 42)	0.262
Day 30	28 (21, 37)	34 (26, 42)	0.324
Day 60	28 (25, 32)	34 (30, 42)	0.034
Day 90	30.5 (28, 35.5)	34 (31, 43)	0.219
Right MCA PI
Baseline	1 (0.7, 1)	0.8 (0.8, 1.1)	0.744
Day 30	1 (0.7, 1)	0.8 (0.8, 1)	0.948
Day 60	0.85 (0.8, 1.05)	0.9 (0.8, 1)	0.917
Day 90	0.9 (0.8, 1.1)	0.9 (0.8, 1.1)	0.972
Left MCA PI
Baseline	1 (0.8, 1.1)	1 (0.8, 1.09)	0.647
Day 30	0.9 (0.8, 1.1)	1 (0.9, 1.09)	0.431
Day 60	0.95 (0.8, 1.05)	1 (0.9, 1.17)	0.422
Day 90	1 (0.8, 1.05)	0.9 (0.8, 1.25)	0.702
Basilar artery PI
Baseline	1 (0.9, 1.1)	0.9 (0.8, 1.1)	0.647
Day 30	1 (1, 1.1)	0.8 (0.8, 1)	0.357
Day 60	0.95 (0.9, 1.05)	0.9 (0.8, 1.1)	0.651
Day 90	0.95 (0.9, 1.05)	1 (0.8, 1.1)	0.862

Abbreviations: MCA, middle cerebral artery; NIHSS, National Institutes of Health Stroke Scale; PI, pulsatility index.

Figure 2 Comparison of responders between study groups during 90-day follow-up.

Note: *A significant difference between both groups was observed, P=0.002.