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Calcium antagonist (PY 108-068) treatment may further decrease flow in ischemic areas in acute stroke
Insights
This study investigated PY 108-068, a new calcium antagonist, for acute ischemic stroke patients. The drug showed limited efficacy, with variable effects on cerebral blood flow (CBF) and no significant clinical improvement.
Area of Science:
- Neurology
- Pharmacology
- Cardiovascular Research
Background:
- Acute ischemic stroke poses a significant health challenge, necessitating novel therapeutic strategies.
- Calcium antagonists are explored for their potential to improve cerebral blood flow (CBF) in stroke patients.
Purpose of the Study:
- To evaluate the effect of a novel calcium antagonist, PY 108-068, on regional cerebral blood flow (CBF) in patients with acute ischemic stroke.
- To assess the safety and efficacy of PY 108-068 at two different intravenous dosage regimens.
Main Methods:
- The study involved two series of acute ischemic stroke patients receiving PY 108-068 intravenously at dosages of 1.5 + 2.5 mg (series 1, n=6) and 2.5 + 5.0 mg (series 2, n=5).
- Cerebral blood flow (CBF) was measured using xenon-133 inhalation and single-photon emission computed tomography (Tomomatic 64) before and after treatment.
- Mean arterial blood pressure (MABP) and clinical symptoms were also monitored.
Main Results:
- In series 1, no significant changes in hemispheric CBF, MABP, or clinical symptoms were observed, although one patient showed localized CBF increase in the periinfarct area.
- Series 2 demonstrated slight increases in mean hemispheric flow, but three out of five patients experienced a further decrease in CBF within the ischemic area.
- Mean arterial blood pressure (MABP) decreased by 13% in series 2, while clinical symptoms remained unchanged across both series.
Conclusions:
- The novel calcium antagonist PY 108-068 demonstrated limited therapeutic benefit in patients with acute ischemic stroke.
- The drug exhibited variable effects on regional cerebral blood flow, with no consistent improvement and even further reductions in some ischemic areas.
- Further research is needed to determine the potential role, optimal dosage, and specific patient populations that might benefit from PY 108-068 or similar agents in stroke management.
Abstract:
The effect of the possible influence of a new calcium antagonist, PY 108-068, on regional CBF was studied in patients suffering acute ischemic stroke. The dosage was 1.5 + 2.5 mg intravenously in six patients (series 1) and 2.5 + 5.0 mg intravenously in five other patients (series 2). CBF was measured before and after treatment by xenon-133 inhalation and single-photon emission computed tomography (Tomomatic 64). In the first series, no changes in hemispheric CBF, MABP, or clinical symptoms were noted after treatment, but one patient showed an increase of CBF in part of the periinfarct area. In the second series, slight increases in mean hemispheric flow values were seen, but in three of the five patients CBF decreased even further in the ischemic area. MABP decreased by 13%, and the clinical symptoms were unchanged.