Background: Prostacyclin is an agent with a number of effects on platelets, blood vessels and nerve cells which might improve outcome after acute ischaemic stroke.
Objectives: The objective of this review was to assess the effect of prostacyclin or analogues on survival in people with acute ischaemic stroke.
Search strategy: We searched the Cochrane Stroke Group trials register (last searched: March 1999), Medline (from 1965), Embase (from 1980) and ISI (from 1981). We contacted drug companies.
Selection criteria: Randomised trials comparing prostacyclin or analogues with placebo or control. Trials where people were entered within one week of stroke onset were included.
Data collection and analysis: Trial quality was assessed.
Main results: Five trials involving 191 people were included. Six early deaths (within four weeks) occurred with prostacyclin and nine with placebo (odds ratio of 0.63, 95% confidence interval 0.22 to 1.85). One trial of 32 patients reported late deaths (by 10 to 18 months) in 50% of patients in each group.
Reviewer's conclusions: Too few patients have been studied in randomised trials to allow conclusions to be drawn about the effect of prostacyclin treatment on survival of people with acute stroke.