Abstract: | |
Inflammation following ischemic brain injury is correlated with adverse outcome. Preclinical studies indicate that treatment with acetylsalicylic acid + extended-release dipyridamole (ASA + ER-DP) has anti-inflammatory and thereby neuroprotective effects by inhibition of monocyte chemotactic protein-1 (MCP-1) expression. We hypothesized that early treatment with ASA + ER-DP will reduce levels of MCP-1 also in patients with ischemic stroke. The EARLY trial randomized patients with ischemic stroke or TIA to either ASA + ER-DP treatment or ASA monotherapy within 24 h following the event. After 7 days, all patients were treated for up to 90 days with ASA + ER-DP. MCP-1 was determined from blood samples taken from 425 patients on admission and day 8. The change in MCP-1 from admission to day 8 did not differ between patients treated with ASA + ER-DP and ASA monotherapy (p > 0.05). Comparisons within MCP-1 baseline quartiles indicated that patients in the highest quartile (> 217-973 pg/mL) showed improved outcome at 90 days if treated with ASA + ER-DP in comparison to treatment with ASA alone (p = 0.004). Our data does not provide any evidence that treatment with ASA + ER-DP lowers MCP-1 in acute stroke patients. However, MCP-1 may be a useful biomarker for deciding on early stroke therapy, as patients with high MCP-1 at baseline appear to benefit from early treatment with ASA + ER-DP.
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License of this version: | CC BY-NC-SA 3.0 Unported - https://creativecommons.org/licenses/by-nc-sa/3.0/ |
Publication type: | Article |
Publishing status: | publishedVersion |
Publication date: | 2012 |
Keywords english: | Acetylsalicylic acid (ASA), Antithrombotic therapy, Dipyridamole, Ischemic stroke, Monocyte chemoattractant protein-1 (MCP-1), Neuroprotection, acetylsalicylic acid, dipyridamole, monocyte chemotactic protein 1, acetylsalicylic acid, antithrombocytic agent, biological marker, CCL2 protein, human, dipyridamole, monocyte chemotactic protein 1, adult, aged, article, brain ischemia, controlled study, disease severity, early intervention, female, human, major clinical study, male, monotherapy, multicenter study, National Institutes of Health Stroke Scale, open study, predictive value, prognosis, protein blood level, randomized controlled trial, transient ischemic attack, blood, drug combination, follow up, middle aged, Stroke, time, very elderly, Adult, Aged, Aged, 80 and over, Aspirin, Biological Markers, Brain Ischemia, Chemokine CCL2, Dipyridamole, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Male, Middle Aged, Platelet Aggregation Inhibitors, Stroke, Time Factors |
DDC: | 540 | Chemie, 570 | Biowissenschaften, Biologie |
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