Nimodipine is a 1,4-dihydropyridine derivative that shows a preferential
cerebrovascular activity in experimental animals. Clinical data suggest that
nimodipine has a beneficial effect on the neurologic outcome of patients
suffering an acute ischemic stroke. Our double-blind placebo-controlled
multicenter trial was designed to assess the effects of oral nimodipine on the
mortality rate and neurologic outcome of patients with an acute ischemic stroke.
One hundred sixty-four patients were randomly allocated to receive either
nimodipine tablets (30 mg q.i.d.) or identical placebo tablets for 28 days.
Treatment was always started less than or equal to 48 hours after the acute
event. The Mathew Scale, slightly modified by Gelmers et al, was used for
neurologic assessment. Mortality rate and neurologic outcome after 28 days were
used as evaluation criteria. We considered 123 patients to be valid for the
analysis of efficacy. Mortality rates did not differ significantly between
groups. Neurologic outcome after 28 days of therapy did not differ between
groups. However, when only those patients most likely to benefit from any
intervention (Mathew Scale sum score of less than or equal to 65 at baseline)
were analyzed separately in post hoc-defined subgroups, the nimodipine-treated
subgroups showed a significantly better neurologic outcome. This result suggests
that some patients with acute ischemic stroke will benefit from treatment with
nimodipine tablets