Heterogeneity Affecting Outcome From Acute Stroke Therapy
| Autor: | Thomas A. Kent, Vicki M. Soukup, Roderic H. Fabian |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
medicine.medical_specialty
genetic structures Inflammation Infections Risk Assessment behavioral disciplines and activities Tissue plasminogen activator Internal medicine medicine Humans Risk factor Stroke Advanced and Specialized Nursing Clinical Trials as Topic Vascular disease business.industry NF-kappa B medicine.disease Recombinant Proteins Surgery Oxidative Stress Treatment Outcome Hyperglycemia Reperfusion Injury Tissue Plasminogen Activator Concomitant Acute Disease Reperfusion Disease Progression Cardiology Etiology Cytokines Neurology (clinical) medicine.symptom Reactive Oxygen Species Cardiology and Cardiovascular Medicine business Reperfusion injury psychological phenomena and processes medicine.drug |
| Zdroj: | Stroke. 32:2318-2327 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/hs1001.096588 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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