Preliminary experience with intra-arterial nicardipine in patients with acute ischemic stroke

“…[733][734][735] Although nicardipine is used to treat elevated blood pressure in the setting of stroke, the agent has had limited testing for neuroprotective treatment of the stroke itself. 736,737 A meta-analysis published in 2000 of the calcium channel-blocking agents found no evidence that this class of drug is effective in improving outcomes after ischemic stroke. 738 Several N-methyl-d-aspartate antagonists have been tested in clinical trials, with largely negative results and increased rates of serious adverse events.…”

Section: Pharmacological Agentsmentioning

confidence: 99%

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Jauch¹,

Saver²,

Adams³

et al. 2013

Stroke

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1,801

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Background and Purpose-The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators responsible for the care of acute ischemic stroke patients within the first 48 hours from stroke onset. These guidelines supersede the prior 2007 guidelines and 2009 updates. Methods-Members of the writing committee were appointed by the American Stroke Association Stroke Council's Scientific Statement Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Panel members were assigned topics relevant to their areas of expertise, reviewed the stroke literature with emphasis on publications since the prior guidelines, and drafted recommendations in accordance with the American Heart Association Stroke Council's Level of Evidence grading algorithm. Results-The goal of these guidelines is to limit the morbidity and mortality associated with stroke. The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses early stroke evaluation and general medical care, as well as ischemic stroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest. Guidelines for the Early Management of PatientsThis statement was approved by the American Heart Association Science Advisory and Coordinating Committee on December 12, 2012. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.The Executive Summary is available as an online-only Data Supplement with this article at http://stroke.ahajournals.org/lookup/suppl/ doi:10.1161/STR.0b013e318284056a/-/DC1.The American Heart Association requests that this document be cited as follows: Jauch EC, Saver JL, Adams HP Jr, Bruno A, Connors JJ, Demaerschalk BM, Khatri P, McMullan PW Jr, Qureshi AI, Rosenfield K, Scott PA, Summers DR, Wang DZ, Wintermark M, Yonas H; on behalf of the American Heart Association Stroke Council, Council on Cardio...

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“…In general, treatment with nicardipine decreased mean arterial pressure by about 10 mmHg and was not accompanied by any procedural or post-procedural complication and induced neurological improvement in patients treated with the CCB alone [37]. Worth of mention is also a very recent investigation evaluating the easy use and tolerability of labetalol versus nicardipine for hypertension management in patients with acute stroke.…”

Section: Strokementioning

confidence: 99%

Nicardipine use in cerebrovascular disease: A review of controlled clinical studies

Amenta

Lanari

Mignini

et al. 2009

Journal of the Neurological Sciences

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Preliminary experience with intra-arterial nicardipine in patients with acute ischemic stroke

Abstract: Intra-arterial delivery of nicardipine in doses up to 5 mg is well tolerated among patients with acute ischemic stroke. Further studies are required to determine the potential efficacy of this approach with or without thrombolytics.

Cited by 16 publications

References 12 publications

Recommendations on Angiographic Revascularization Grading Standards for Acute Ischemic Stroke

Recommendations on Angiographic Revascularization Grading Standards for Acute Ischemic Stroke

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Nicardipine use in cerebrovascular disease: A review of controlled clinical studies

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