Favorable Outcome of Ischemic Stroke in Patients Pretreated with Statins

Martí‐Fàbregas, Joan; Gomis, Meritxell; Arboix, Adrià; Aleu, Aitzíber; Pagonabarraga, Javier; Belvís, R.; Cocho, Dolores; Roquer, Jaume; Rodríguez, A.; García, María Dolores Aguilar; Molina‐Porcel, Laura; Díaz‐Manera, Jordi; Martí-Vilalta, Josep-Lluis

doi:10.1161/01.str.0000125863.93921.3f

Cited by 184 publications

(147 citation statements)

References 32 publications

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“…However, this decreased MMP-9 level did not result in improved clinical outcome [61] . While atorvastatin has previously been shown to correlate with reduced incidence [62] and improved neurological outcomes in cerebrovascular disease, these results highlight the potential link between statins and serum MMP inhibition in neurologic injury [63][64][65][66] . Sinn et al demonstrated that valproic acid (VPA) treatment in rats with ICH decreased levels of MMP-9 mRNA.…”

Section: Chang Jj Et Al Mmp Regulation In Intracerebral Hemorrhagementioning

confidence: 70%

Matrix Metalloproteinase Regulation in Intracerebral Hemorrhage

Chang

Jones

Betlachin

et al. 2015

International Journal of Neurology Research

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Intracerebral hemorrhage remains a particularly devastating form of cerebrovascular disease with unchanged mortality rates despite several large studies that have targeted primary expansion of hematoma growth. A second, worthwhile target for improving clinical outcome after intracerebral hemorrhage may be neuroprotection through modulation of secondary mechanisms of brain injury. Matrix metalloproteinases represent a family of ubiquitous endopeptidase enzymes that can become pathologically activated and result in blood-brain barrier breakdown. In humans, high levels of matrix metalloproteinase have been associated with perihematomal edema, symptomatic hemorrhagic transformation, and worse clinical outcome. As a result, inhibition of matrix metalloproteinase in the acute phase of intracerebral hemorrhage may represent an efficacious strategy for improving clinical outcome. Current strategies for inhibiting matrix metalloproteinase in intracerebral hemorrhage are as follows: (1) direct inhibition, (2) transcriptional control of matrix metalloproteinase expression, and (3) post-transcriptional control. Currently, the most clinically relevant form of matrix metalloproteinase inhibition lies with direct inhibition through broad-spectrum hydroxamate-class inhibitors and tetracycline-class antibiotics and the polymechanistic role of statins. Further trials are necessary to evaluate for possible roles of matrix metalloproteinase inhibition in improving clinical outcome after intracerebral hemorrhage.

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Section: Chang Jj Et Al Mmp Regulation In Intracerebral Hemorrhagementioning

confidence: 70%

Matrix Metalloproteinase Regulation in Intracerebral Hemorrhage

Chang

Jones

Betlachin

et al. 2015

International Journal of Neurology Research

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“…decreasing incidence of cortical infarcts). Indeed, statin (HMG-coA reductase inhibitor) and fibrates decrease the CRP levels, and favorable outcome among ischemic stroke patients pretreated with statin was recently reported [36,37]. Further investigations are warranted to elucidate the effects of these agents as a potential stroke phenotype modifier.…”

Section: Discussionmentioning

confidence: 99%

Non-conventional risk factors were associated with infarct patterns in ischemic stroke

Yoon

Bang

Hong

et al. 2009

Clinical Neurology and Neurosurgery

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“…Besides the effect of statin treatment in stroke prevention, it has also been shown that statins (HMG-CoA reductase inhibitors) have other beneficial effects and these may be independent of the subject's basal lipid levels (47,86). In fact, recent studies suggest a neuroprotective power in the acute phase of stroke.…”

Section: Other Treatmentsmentioning

confidence: 99%

Stroke pathophysiology: management challenges and new treatment advances

Jordán

Ikuta

García-García

et al. 2007

J. Physiol. Biochem.

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J. JORDÁN, I. IKUTA, J. GARCÍA-GARCÍA, S. CALLEJA and T. SEGURA. Stroke pathophysiology: Management challenges and new treatment advances (minireview). J. Physiol. Biochem., 63 (3), 261-278, 2007. Stroke is the second leading cause of death and the first cause of lost disabilityadjusted years in developed countries. During the past decade, new developments in thrombolytic therapy have led to the implementation of emergency intervention protocols for the treatment of ischemic stroke, replacing the widespread sense of therapeutic nihilism in the past. Treatment with rtPA has shown to be effective within the first 3 hours following stroke onset and the FDA and the European Medical Agency (EMEA) have approved its use. Acknowledging the urgency and intricacies of stroke, Stroke Units allow the monitoring of physiological parameters in the acute phase of stroke and are considered an important management tool that can significantly improve the quality of care provided to the patient. The concept of neuroprotective therapy for acute ischemic stroke to salvage tissue at risk and improve functional outcome is based on sound scientific principles and extensive preclinical animal studies demonstrating efficacy. However, most neuroprotective drugs in clinical trials have failed, possibly due to inadequate preclinical testing or flawed clinical development programs. Several new treatment strategies are under development and are being tested. This review is directed at understanding the management of acute ischemic stroke pathophysiology. We address the management challenges and new treatment advances by integrating the knowledge of possible pharmacological targets for acute ischemic stroke. We hope to shed new light upon the controversy surrounding the management of acute ischemic stroke in an attempt to elucidate why failed clinical trials continue to occur despite promising neuroprotective preclinical studies.

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Favorable Outcome of Ischemic Stroke in Patients Pretreated with Statins

Abstract: Background and Purpose-Statins may be beneficial for patients with acute ischemic stroke. We tested the hypothesis that patients pretreated with statins at the onset of stroke have less severe neurological effects and a better outcome.

Cited by 184 publications

References 32 publications

Matrix Metalloproteinase Regulation in Intracerebral Hemorrhage

Matrix Metalloproteinase Regulation in Intracerebral Hemorrhage

Non-conventional risk factors were associated with infarct patterns in ischemic stroke

Stroke pathophysiology: management challenges and new treatment advances

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