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Current and future perspectives on the treatment of cerebral ischemia.

Abstract After heart disease and combined forms of cancer, stroke is the leading cause of death in the United States. Currently, tissue-plasminogen activator (tPA) thrombolysis is the only thrombolytic therapy that has been shown to improve patient outcome. Presently, the only antithrombotic drug treatment that has proven effective at improving acute ischemic stroke patient outcome is aspirin administration. Despite these studies, no clinical trials have yet demonstrated a reliably effective pharmacological treatment. Areas covered: We conducted a search of recent drug studies for ischemic stroke on clinicaltrials.gov in addition to a literature search for acute ischemic stroke therapy using PubMed. This review details our findings of recent advancements in the pharmacological treatment of acute ischemic stroke. Expert commentary: We concluded that recent attempts to establish new pharmacological treatment protocols for acute ischemic stroke have had limited success, but many Phase III and Phase IV clinical trials demonstrate promise. Moreover, several studies have demonstrated the efficacy of dual-antiplatelet therapies at reducing risk of secondary stroke. Studies for novel therapeutic targets for neuroprotection have been largely unsuccessful. Some trials had positive results; however, there is much room for improvement and other studies show promise in their preliminary stages.
PMID
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Authors

Mayor MeshTerms
Keywords

Ischemia

antithrombotic

neuroprotection

pharmacotherapy

reperfusion

stroke

thrombolysis

Journal Title expert opinion on pharmacotherapy
Publication Year Start




PMID- 28393614
OWN - NLM
STAT- MEDLINE
DA  - 20170410
DCOM- 20170417
LR  - 20170417
IS  - 1744-7666 (Electronic)
IS  - 1465-6566 (Linking)
VI  - 18
IP  - 6
DP  - 2017 Apr
TI  - Current and future perspectives on the treatment of cerebral ischemia.
PG  - 573-580
LID - 10.1080/14656566.2017.1309022 [doi]
AB  - INTRODUCTION: After heart disease and combined forms of cancer, stroke is the
      leading cause of death in the United States. Currently, tissue-plasminogen
      activator (tPA) thrombolysis is the only thrombolytic therapy that has been shown
      to improve patient outcome. Presently, the only antithrombotic drug treatment
      that has proven effective at improving acute ischemic stroke patient outcome is
      aspirin administration. Despite these studies, no clinical trials have yet
      demonstrated a reliably effective pharmacological treatment. Areas covered: We
      conducted a search of recent drug studies for ischemic stroke on
      clinicaltrials.gov in addition to a literature search for acute ischemic stroke
      therapy using PubMed. This review details our findings of recent advancements in 
      the pharmacological treatment of acute ischemic stroke. Expert commentary: We
      concluded that recent attempts to establish new pharmacological treatment
      protocols for acute ischemic stroke have had limited success, but many Phase III 
      and Phase IV clinical trials demonstrate promise. Moreover, several studies have 
      demonstrated the efficacy of dual-antiplatelet therapies at reducing risk of
      secondary stroke. Studies for novel therapeutic targets for neuroprotection have 
      been largely unsuccessful. Some trials had positive results; however, there is
      much room for improvement and other studies show promise in their preliminary
      stages.
FAU - Christophe, Brandon R
AU  - Christophe BR
AD  - a Department of Neurological Surgery , Columbia University Medical Center , New
      York , NY , USA.
FAU - Mehta, Shyle H
AU  - Mehta SH
AD  - a Department of Neurological Surgery , Columbia University Medical Center , New
      York , NY , USA.
FAU - Garton, Andrew L A
AU  - Garton AL
AD  - a Department of Neurological Surgery , Columbia University Medical Center , New
      York , NY , USA.
FAU - Sisti, Jonathan
AU  - Sisti J
AD  - a Department of Neurological Surgery , Columbia University Medical Center , New
      York , NY , USA.
FAU - Connolly, E Sander Jr
AU  - Connolly ES Jr
AD  - a Department of Neurological Surgery , Columbia University Medical Center , New
      York , NY , USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Expert Opin Pharmacother
JT  - Expert opinion on pharmacotherapy
JID - 100897346
RN  - 0 (Fibrinolytic Agents)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aspirin/therapeutic use
MH  - Brain Ischemia/*drug therapy
MH  - Fibrinolytic Agents/therapeutic use
MH  - Humans
MH  - Stroke/*drug therapy
MH  - Thrombolytic Therapy
MH  - Tissue Plasminogen Activator/*therapeutic use
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *Ischemia
OT  - *antithrombotic
OT  - *neuroprotection
OT  - *pharmacotherapy
OT  - *reperfusion
OT  - *stroke
OT  - *thrombolysis
EDAT- 2017/04/11 06:00
MHDA- 2017/04/18 06:00
CRDT- 2017/04/11 06:00
AID - 10.1080/14656566.2017.1309022 [doi]
PST - ppublish
SO  - Expert Opin Pharmacother. 2017 Apr;18(6):573-580. doi:
      10.1080/14656566.2017.1309022.

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