Controlled trial of ancrod in ischemic stroke

Area of Science:

• Neurology
• Hematology
• Pharmacology

Background:

• Acute ischemic stroke is a leading cause of disability and mortality.
• Current treatments aim to restore blood flow and minimize brain damage.
• The role of blood viscosity and coagulation in stroke pathophysiology is significant.

Purpose of the Study:

• To evaluate the efficacy and safety of ancrod, a viper venom enzyme, in patients with acute ischemic stroke.
• To assess the impact of ancrod on blood viscosity, fibrinogen levels, and neurological outcomes.
• To compare ancrod treatment with standard therapy (dextran and mannitol).

Main Methods:

• A randomized, single-blind study involving 30 acute ischemic stroke patients.
• Patients were divided into two groups: Group A (dextran and mannitol) and Group B (ancrod plus dextran and mannitol).
• Measurements included plasma fibrinogen, blood viscosity, fibrin degradation products, plasminogen levels, coagulation tests, platelet function, and neurological scores.

Main Results:

• Ancrod treatment significantly reduced blood viscosity by 37% compared to 7% in the control group.
• Fibrinogen levels were lowered, fibrin degradation products increased, and plasminogen decreased in the ancrod group.
• Neurological scores improved more in the ancrod group (2.6 AU) than in the control group (1.1 AU).
• Mortality was lower in the ancrod group (2 deaths) compared to the control group (5 deaths) within the first two weeks.

Conclusions:

• Ancrod demonstrates a potential beneficial effect in acute ischemic stroke patients.
• The therapeutic benefit may stem from ancrod's anticoagulative and fibrinolytic properties.
• Further research is warranted to confirm these preliminary findings and optimize ancrod therapy.