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Stroke Treatment With PAR-1 Agents to Decrease Hemorrhagic Transformation.

Patrick D Lyden1, Kent E Pryor2, Jennifer Minigh3

  • 1Department of Physiology and Neuroscience, Keck School of Medicine, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles, CA, United States.

Frontiers in Neurology
|April 1, 2021
PubMed
Summary
This summary is machine-generated.

New therapies targeting protease activated receptor 1 (PAR-1) may reduce brain hemorrhage risk after ischemic stroke treatments like tissue plasminogen activator (tPA). This could increase treatment eligibility and improve patient outcomes.

Keywords:
activated protein Cbleedinghemorrhagic transformationintracranial hemorrhageischemic strokestroke therapythrombectomytissue plasminogen activator

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Ischemic stroke is a major cause of death and disability globally.
  • Current recanalization therapies (tPA, thrombectomy) have limited uptake due to restrictive criteria and hemorrhage risks.
  • Hemorrhagic transformation post-recanalization significantly worsens stroke outcomes.

Purpose of the Study:

  • To review current stroke therapies and the impact of hemorrhagic transformation.
  • To present evidence for protease activated receptor 1 (PAR-1) targeted therapies as adjuncts to recanalization.
  • To assess the potential of PAR-1 agents in reducing hemorrhagic transformation and improving stroke outcomes.

Main Methods:

  • Narrative review of existing literature on stroke treatments.
  • Analysis of translational research and clinical data on PAR-1 inhibitors.
  • Discussion of the role of PAR-1 in hemorrhagic transformation following ischemic stroke.

Main Results:

  • Protease activated receptor 1 (PAR-1) targeted therapies show promise in reducing hemorrhagic transformation.
  • Adjunctive PAR-1 inhibition may mitigate a key risk associated with thrombolysis and thrombectomy.
  • Expanded eligibility criteria for recanalization therapies could be better utilized with safer treatment options.

Conclusions:

  • PAR-1 targeted agents represent a promising strategy to decrease hemorrhagic transformation after ischemic stroke.
  • These adjunct therapies may enhance the safety and applicability of recanalization treatments.
  • Wider adoption of recanalization therapies could be facilitated by agents that improve patient outcomes by reducing hemorrhage risk.