Heterogeneity affecting outcome from acute stroke therapy: making reperfusion worse.

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.

journal_name

Stroke

journal_title

Stroke

authors

Kent TA,Soukup VM,Fabian RH

doi

10.1161/hs1001.096588

subject

Has Abstract

pub_date

2001-10-01 00:00:00

pages

2318-27

issue

10

eissn

0039-2499

issn

1524-4628

journal_volume

32

pub_type

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