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Systematic Review - Combining Neuroprotection With Reperfusion in Acute Ischemic Stroke.
Vos, E M; Geraedts, V J; van der Lugt, A; Dippel, D W J; Wermer, M J H; Hofmeijer, J; van Es, A C G M; Roos, Y B W E M; Peeters-Scholte, C M P C D; van den Wijngaard, I R.
Afiliación
  • Vos EM; Department of Neurology, The Hague Medical Center, The Hague, Netherlands.
  • Geraedts VJ; Department of Neurology, The Hague Medical Center, The Hague, Netherlands.
  • van der Lugt A; Department of Neurology, Leiden University Medical Center, Leiden, Netherlands.
  • Dippel DWJ; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, Netherlands.
  • Wermer MJH; Department of Neurology, Erasmus University Medical Center, Rotterdam, Netherlands.
  • Hofmeijer J; Department of Neurology, Leiden University Medical Center, Leiden, Netherlands.
  • van Es ACGM; Department of Neurology, Rijnstate Hospital, Arnhem, Netherlands.
  • Roos YBWEM; Department of Clinical Neurophysiology, Technical Medical Centre, University of Twente, Enschede, Netherlands.
  • Peeters-Scholte CMPCD; Department of Radiology, Leiden University Medical Center, Leiden, Netherlands.
  • van den Wijngaard IR; Department of Radiology, The Hague Medical Center, The Hague, Netherlands.
Front Neurol ; 13: 840892, 2022.
Article en En | MEDLINE | ID: mdl-35370911
Background: Clinical trials of neuroprotection in acute ischemic stroke (AIS) have provided disappointing results. Reperfusion may be a necessary condition for positive effects of neuroprotective treatments. This systematic review provides an overview of efficacy of neuroprotective agents in combination with reperfusion therapy in AIS. Methods: A literature search was performed on the following databases, namely PubMed, Embase, Web of Science, Cochrane Library, Emcare. All databases were searched up to September 23rd 2021. All randomized controlled trials in which patients were treated with neuroprotective strategies within 12 h of stroke onset in combination with intravenous thrombolysis (IVT), endovascular therapy (EVT), or both were included. Results: We screened 1,764 titles/abstracts and included 30 full reports of unique studies with a total of 16,160 patients. In 15 studies neuroprotectants were tested for clinical efficacy, where all patients had to receive reperfusion therapies, either IVT and/or EVT. Heterogeneity in reported outcome measures was observed. Treatment was associated with improved clinical outcome for: 1) uric acid in patients treated with EVT and IVT, 2) nerinetide in patients who underwent EVT without IVT, 3) imatinib in stroke patients treated with IVT with or without EVT, 4) remote ischemic perconditioning and IVT, and 5) high-flow normobaric oxygen treatment after EVT, with or without IVT. Conclusion: Studies specifically testing effects of neuroprotective agents in addition to IVT and/or EVT are scarce. Future neuroprotection studies should report standardized functional outcome measures and combine neuroprotective agents with reperfusion therapies in AIS or aim to include prespecified subgroup analyses for treatment with IVT and/or EVT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Systematic_reviews Idioma: En Revista: Front Neurol Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Systematic_reviews Idioma: En Revista: Front Neurol Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Suiza