Heterogeneity affecting outcome from acute stroke therapy making reperfusion worse

Thomas A. Kent, Vicki M. Soukup, Roderic H. Fabian

Research output: Contribution to journalArticle

74 Scopus citations

Abstract

Background - Stroke patients are heterogeneous not only with respect to etiology but also in terms of preexisting clinical conditions. Approximately one fifth of patients with acute stroke are hyperglycemic and/or have had a recent infectious or inflammatory condition. Summary of Review - Experimental research indicates that these factors can alter and accelerate the evolution of stroke and reperfusion injury, although these effects are complex and some may have a favorable impact. Both conditions involve activation of inflammatory and reactive oxygen mechanisms. In addition, hyperglycemia has concomitant deleterious vascular and metabolic effects that worsen infarct size and encourage hemorrhagic transformation in reperfusion models. Clinical data are less extensive but in general support an adverse impact on outcome. Conclusions - After examining these data in detail, we concluded that the presence of these clinical conditions could assist in identification of those at increased risk for complications of reperfusion therapy. Furthermore, consideration of these factors may provide a rational basis for combination therapy and improve the clinical relevance of experimental stroke models.

Original languageEnglish (US)
Pages (from-to)2318-2327
Number of pages10
JournalStroke
Volume32
Issue number10
DOIs
StatePublished - 2001

Keywords

  • Cytokines
  • Hyperglycemia
  • Reperfusion injury
  • Stroke
  • Tissue plasminogen activator

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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