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Cytoprotective agents in stroke: Still uncertainty in the next frontier.
Siddiqi, A Zohaib; Kashani, Nima; Dmytriw, Adam A; Yavagal, Dileep R; Saposnik, Gustavo; Tymianski, Michael; Adams, Corey; Hill, Michael D; Dowlatshahi, Dar; Katsanos, Aristeidis H; Menon, Bijoy K; Ganesh, Aravind; Singh, Nishita.
Afiliación
  • Siddiqi AZ; Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
  • Kashani N; Department of Radiology, University of Manitoba, Winnipeg, MB, Canada.
  • Dmytriw AA; Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston MA.
  • Yavagal DR; Cerebral Vascular Disease Research Laboratories, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
  • Saposnik G; Division of Neurology, St Michael's Hospital, University of Toronto, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Canada; Research Department, NeuroEconSolutions (Neuroeconsolutions.com), Toronto, Canada.
  • Tymianski M; NoNO Inc., Toronto, Canada (M.T.).
  • Adams C; Calgary Stroke Program, Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Hill MD; Department of Radiology, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; O'Brien Institute for
  • Dowlatshahi D; Department of Medicine, Ottawa Hospital Research Institute and University of Ottawa, ON Canada.
  • Katsanos AH; Division of Neurology, McMaster University & Population Health Research Institute, Hamilton, ON Canada.
  • Menon BK; Calgary Stroke Program, Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; O'Brien Institute for Public Health, Cumming School
  • Ganesh A; Calgary Stroke Program, Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calg
  • Singh N; Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: nishitaneurology@gmail.com.
J Stroke Cerebrovasc Dis ; 33(9): 107860, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38997049
ABSTRACT

INTRODUCTION:

Despite substantial improvement of acute ischemic stroke (AIS) care with the advent of extended time windows for intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT), a substantial portion of patients still suffer poor outcomes. Additional adjuvant therapies are needed but pharmacologic interactions among therapies may dictate how they could be used. We conducted a survey to determine physician decision-making regarding the use of cytoprotective agents in patients presenting with AIS.

METHODS:

The survey was structured, web-based, anonymous, and invite-only among physicians across the world treating patients presenting with AIS. Respondents were asked about the use of a hypothetical cytoprotective agent (that provided an added 10% benefit) in the context of a treatment interaction with IVT or its timing in relation to IVT.

RESULTS:

A total of 282 stroke physicians (74.9% males, mean age 46 years) participated in the survey. When the respondent could give both the cytoprotective agent and IVT with no treatment interaction, 177 (78.0%) chose to administer both. In the presence of treatment interaction, 88 (38.3%) would withhold IVT, 83 (36.1%) would withhold the cytoprotective agent and 56 (24.4%) were uncertain. Lastly, 111 (48.9%) were willing to administer the cytoprotective agent if it meant a necessary 10-minute delay in IVT administration.

CONCLUSIONS:

Pharmacologic interactions result in major uncertainty about cytoprotective treatment choices.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Terapia Trombolítica / Fibrinolíticos / Toma de Decisiones Clínicas / Accidente Cerebrovascular Isquémico Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
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PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Terapia Trombolítica / Fibrinolíticos / Toma de Decisiones Clínicas / Accidente Cerebrovascular Isquémico Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos