Tactics for vascular protection after acute ischemic stroke

Susan C. Fagan, David C Hess, Livia S. Machado, Elizabeth J. Hohnadel, David M. Pollock, Adviye Ergul

Research output: Contribution to journalReview article

33 Citations (Scopus)

Abstract

Background. The vascular events that happen during ischemic stroke worsen outcomes in patients by causing edema, hemorrhagic transformation, and general neurologic tissue compromise. In the past 2 decades, clinical trials in patients after ischemic stroke focused on neuroprotection, but these strategies have failed in providing actual benefit. Vascular protection represents a new field to be explored in acute ischemic stroke in order to develop new approaches to therapeutic intervention. Purpose. We identified tactics likely to provide vascular protection in patients with ischemic stroke. These tactics are based on knowledge of the molecular processes involved. Summary of Review. The pathologic processes due to vascular injury after an occlusion of a cerebral artery can be separated into acute (those occurring within hrs), subacute (hrs to days), and chronic (days to mo). Targets for intervention can be identified for all three stages. In the acute phase, superoxide is the predominant mediator, followed by inflammatory mediators and proteases in the subacute phase. In the chronic phase, proapoptotic gene products have been implicated. Many already-marketed therapeutic agents (statins, angiotensin modulators, erythropoietin, minocycline, and thiazolidinediones), with proven safety in patients, have been shown to have activity against some of the key targets of vascular protection. Conclusion. Currently available pharmacologic agents are poised for clinical trials of vascular protection after acute ischemic stroke.

Original languageEnglish (US)
Pages (from-to)387-395
Number of pages9
JournalPharmacotherapy
Volume25
Issue number3
DOIs
StatePublished - Mar 1 2005

Fingerprint

Blood Vessels
Stroke
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Thiazolidinediones
Minocycline
Angiotensins
Erythropoietin
Clinical Trials
Cerebral Arteries
Vascular System Injuries
Pathologic Processes
Patient Safety
Superoxides
Nervous System
Edema
Peptide Hydrolases
Therapeutics
Genes

Keywords

  • Acute ischemic stroke
  • Molecular processes
  • Vascular protection

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Fagan, S. C., Hess, D. C., Machado, L. S., Hohnadel, E. J., Pollock, D. M., & Ergul, A. (2005). Tactics for vascular protection after acute ischemic stroke. Pharmacotherapy, 25(3), 387-395. https://doi.org/10.1592/phco.25.3.387.61592

Tactics for vascular protection after acute ischemic stroke. / Fagan, Susan C.; Hess, David C; Machado, Livia S.; Hohnadel, Elizabeth J.; Pollock, David M.; Ergul, Adviye.

In: Pharmacotherapy, Vol. 25, No. 3, 01.03.2005, p. 387-395.

Research output: Contribution to journalReview article

Fagan, SC, Hess, DC, Machado, LS, Hohnadel, EJ, Pollock, DM & Ergul, A 2005, 'Tactics for vascular protection after acute ischemic stroke', Pharmacotherapy, vol. 25, no. 3, pp. 387-395. https://doi.org/10.1592/phco.25.3.387.61592
Fagan SC, Hess DC, Machado LS, Hohnadel EJ, Pollock DM, Ergul A. Tactics for vascular protection after acute ischemic stroke. Pharmacotherapy. 2005 Mar 1;25(3):387-395. https://doi.org/10.1592/phco.25.3.387.61592
Fagan, Susan C. ; Hess, David C ; Machado, Livia S. ; Hohnadel, Elizabeth J. ; Pollock, David M. ; Ergul, Adviye. / Tactics for vascular protection after acute ischemic stroke. In: Pharmacotherapy. 2005 ; Vol. 25, No. 3. pp. 387-395.
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