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Tactics for vascular protection after acute ischemic stroke
Susan C Fagan1, David C Hess, Livia S Machado
1Program in Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, Georgia 30912-2450, USA. sfagan@mail.mcg.edu
Pharmacotherapy
|April 22, 2005
Summary
Vascular protection strategies are emerging as a new therapeutic avenue for acute ischemic stroke, moving beyond neuroprotection. Existing drugs show promise for clinical trials targeting vascular injury mechanisms.
Area of Science:
- Neurology
- Vascular Biology
- Pharmacology
Background:
- Ischemic stroke leads to edema, hemorrhagic transformation, and neurological damage via vascular events.
- Past neuroprotection trials have yielded limited patient benefit.
- Vascular protection offers a novel therapeutic approach for acute ischemic stroke.
Purpose of the Study:
- Identify vascular protection tactics for ischemic stroke patients.
- Leverage molecular processes knowledge for therapeutic strategies.
Main Methods:
- Analysis of pathological processes in acute, subacute, and chronic phases of ischemic stroke.
- Identification of therapeutic targets at each stage.
- Review of existing pharmacologic agents with proven safety profiles.
Main Results:
- Acute phase targets superoxide; subacute phase targets inflammation and proteases; chronic phase targets proapoptotic factors.
- Existing drugs like statins, angiotensin modulators, erythropoietin, minocycline, and thiazolidinediones demonstrate activity against key vascular protection targets.
- These agents have established safety profiles in patients.
Conclusions:
- Pharmacologic agents currently available are suitable for clinical trials focused on vascular protection in acute ischemic stroke.
- Vascular protection represents a promising new direction for stroke therapeutics.