Cytoprotective Agents in Stroke: Still Uncertainty in the Next Frontier.

Siddiqi, A Zohaib; Kashani, N; Dmytriw, A; Yavagal, D; Saposnik, G; Tymianski, M; Adams, C; Hill, M D; Dowlatshahi, Dar; Katsanos, Aristeidis H; Menon, B K; Ganesh, A; Singh, N

Siddiqi, A Zohaib; Kashani, N; Dmytriw, A; Yavagal, D; Saposnik, G; Tymianski, M; Adams, C; Hill, M D; Dowlatshahi, Dar; Katsanos, Aristeidis H; Menon, B K; Ganesh, A; Singh, N.

Afiliação

Siddiqi AZ; Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: siddiqia@myumanitoba.ca.
Kashani N; Department of Radiology, University of Manitoba, Winnipeg, MB, Canada. Electronic address: nimamani2@gmail.com.
Dmytriw A; Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston MA. Electronic address: adam.dmytriw@gmail.com.
Yavagal D; Cerebral Vascular Disease Research Laboratories, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA. Electronic address: dyavagal@gmail.com.
Saposnik G; Division of Neurology, St Michael's Hospital, University of Toronto, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Canada; Research Department, NeuroEconSolutions (Neuroeconsolutions.com), Toronto, Canada. Electronic address: gustavo.saposnik@unityhealth.to.
Tymianski M; NoNO Inc., Toronto, Canada (M.T.). Electronic address: Mike.Tymianski@uhn.ca.
Adams C; Calgary Stroke Program, Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.. Electronic address: cadams@nonoinc.ca.
Hill MD; Department of Radiology, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.; O'Brien Institute fo
Dowlatshahi D; Department of Medicine, Ottawa Hospital Research Institute and University of Ottawa, ON Canada. Electronic address: ddowlat@toh.ca.
Katsanos AH; Division of Neurology, McMaster University & Population Health Research Institute, Hamilton, ON Canada.. Electronic address: aristeidis.katsanos@phri.ca.
Menon BK; Calgary Stroke Program, Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.; O'Brien Institute for Public Health, Cumming Schoo
Ganesh A; Calgary Stroke Program, Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.; Department of Radiology, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Cal
Singh N; Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: nishitaneurology@gmail.com.

J Stroke Cerebrovasc Dis ; : 107860, 2024 Jul 10.

Article em En | MEDLINE | ID: mdl-38997049

ABSTRACT

ABSTRACT

INTRODUCTION:

Despite substantial improvement of acute ischemic stroke (AIS) care with the advent of extended time windows for intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT), a substantial portion of patients still suffer poor outcomes. Additional adjuvant therapies are needed but pharmacologic interactions among therapies may dictate how they could be used. We conducted a survey to determine physician decision-making regarding the use of cytoprotective agents in patients presenting with AIS.

METHODS:

The survey was structured, web-based, anonymous, and invite-only among physicians across the world treating patients presenting with AIS. Respondents were asked about the use of a hypothetical cytoprotective agent (that provided an added 10% benefit) in the context of a treatment interaction with IVT or its timing in relation to IVT.

RESULTS:

A total of 282 stroke physicians (74.9% males, mean age 46 years) participated in the survey. When the respondent could give both the cytoprotective agent and IVT with no treatment interaction, 177 (78.0%) chose to administer both. In the presence of treatment interaction, 88 (38.3%) would withhold IVT, 83 (36.1%) would withhold the cytoprotective agent and 56 (24.4%) were uncertain. Lastly, 111 (48.9%) were willing to administer the cytoprotective agent if it meant a necessary 10-minute delay in IVT administration.