Antithrombotic treatment as primary and secondary prevention of stroke

Chukanova E.I.

Rossiĭskiĭ gosudarstvennyĭ meditsinskiĭ universitet, Moskva

Chukanova A.S.

Nadareyshvili G.G.

Pirogov Russian National Research Medical University, Moscow, Russia

Gulieva M.Sh.

Pirogov Russian National Research Medical University, Moscow, Russia

Antithrombotic treatment as primary and secondary prevention of stroke

Authors:

Chukanova E.I., Chukanova A.S., Nadareyshvili G.G., Gulieva M.Sh.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2016;116(10): 85‑88

DOI: 10.17116/jnevro201611610185-88

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To cite this article:

Chukanova EI, Chukanova AS, Nadareyshvili GG, Gulieva MSh. Antithrombotic treatment as primary and secondary prevention of stroke. S.S. Korsakov Journal of Neurology and Psychiatry. 2016;116(10):85‑88. (In Russ.)
https://doi.org/10.17116/jnevro201611610185-88

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The use of antithrombotic drugs (ATD) is necessary in the treatment and prevention of thrombosis. The correction of risk factors of ischemic stroke (IS) and transitory ischemic attacks (TIA) is important as well. The drugs inhibiting the activation and aggregation of thrombocytes allow to decrease the number of myocardial infarctions by 35%, stroke by 25% and mortality from cardiovascular causes by 15%. Currently, the clinical efficacy of acetylsalicylic acid (ASA), thienopyridines (ticlopidine, clopidogrel), dipyridamole or the combination of dipyridamole and ASA as well as glycoprotein antagonists IIb-IIIa for intravenous introduction have been confirmed. A review of experimental and clinical studies confirming the efficacy of dipyridamole in the treatment of acute stage of stroke and primary and secondary prevention of II is presented.

Keywords:

cerebrovascular disease

ischemic stroke

endothelial dysfunction

antitrombotic druds

dipyridamol

Authors:

Chukanova E.I.

Rossiĭskiĭ gosudarstvennyĭ meditsinskiĭ universitet, Moskva

Chukanova A.S.

Nadareyshvili G.G.

Pirogov Russian National Research Medical University, Moscow, Russia

Gulieva M.Sh.

Pirogov Russian National Research Medical University, Moscow, Russia

List of references:

Gusev EI, Skvorcova VI, Stahovskaja LV. Jepidemiologija insul'ta v Rossii. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova (Prilozhenie «Insul't»). 2003;8:4-9. (In Russ.).
Chukanova EI. Discirkuljatornaja jencefalopatija (Klinika, diagnostika, lechenie): Dis. ... d-ra med. nauk. 2004. (In Russ.).
Jin K, Zhu Y, Sun Y, Mao XO, Xie L, Greenberg DA. Vascular endothelial growth factor (VEGF) stimulates neurogenesis in vitro and in vivo. Proc Natl Acad Sci USA. 2002;3:99(18):11946-11950. doi: 10.1073/pnas.182296499
Hinderliter AL, Caughey M. Assessing endothelial function as a risk factor for cardiovascular disease. Curr Atheroscler Rep. 2003;5, 6:506-513. doi: 10.1007/s11883-003-0042-x
Yung Y, Rosenberg GA. Blood-brain barrier breakdown in acute and chronic cerebrovascular disease. Stroke. 2011;42:11:3323-3328. doi: 10.1161/strokeaha.110.608257
Chukanova EI, Chukanova AS, Mamaeva HI. Rezul'taty issledovanija jeffektivnosti i bezopasnosti primenenija meksidola u pacientov s hronicheskoj ishemiej mozga. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2015;2:71-74. (In Russ.).
Luscher TF, Noll G. The endothelium as a regulator of vascular tone and growth. The endothelium in cardiovascular disease: pathophysiology, clinical presentation, and pharmacotherapy. Berlin. 1995. doi: 10.1007/978-3-642-79803-0_1
Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002;324:71-86. doi: 10.1136/bmj.324.7329.71
Popova LV, Bokarev IN, Arkad'eva GV, Radzevich AJe, Mazurov AV. Protivotrombocitarnaja terapija v klinicheskoj praktike. Metodicheskie rekomendacii. 2007. (In Russ.).
Albers GW, Easton JD, Sacco RL, Teal P. Antithrombotic and thrombolytic therapy for ischemic stroke. Chest. 1998;1146:683-698. doi: 10.1378/chest.114.5_supplement.683s
Fitzgerald GA. Dipyridamole. N Engl J Med. 1987;316:1247-1257.
Balacumar P, Nyo YH, Renushia R, Raaginey D, Oh AN, Varathalingam R, Dhanaraj SA. Classical and pleotropic action of dipyridamole: Not enough light to illuminate the dark tunnel? Pharmacological Research. 2014;87:144-150. doi: 10.1016/j.phrs.2014.05.008
Heistad DD, Marcus ML, Gourley JK, Busija DW. Effect of adenosine and dipyridamole on cerebral blood flow. Am J Physiol. 1981;240:775-780.
Cheng Y, Austin SC, Rocca B, Koller BH, Coffman TM, Grosser T, Lawson JA, FitzGerald GA. Role of prostacyclin in the cardiovascular response to thromboxane A2. Science. 2002;296:539-541. doi: 10.1126/science.1068711
Vorob'eva OV. Antitrombocitarnye i nejroprotektivnye jeffekty dipiridamola (ot klinicheskih modelej k praktike). Trudnyj pacient. 2010;3-7. (In Russ.).
Iuliano L, Pedersen JZ, Rotilio G. A potent chain-breaking antioxidant activity of the cardiovascular drug dipyridamole. Free Radic Biol Med. 1995;18:239-247. doi: 10.1016/0891-5849(94)e0123-z
Reilly IA, Fitzgerald GA. Inhibition of thromboxane formation in vivo and ex vivo: Implications for therapy with platelet inhibitory drugs. Blood. 1987;69:180-186.
Kusmic C, Petersen E, Picano E. Antioxidant effect of oral dipyridamole during cerebral hypoperfusion with human carotid endarterectomy. J Cardiovasc Pharmacol. 2000;36. doi: 10.1097/00005344-200008000-00001
Hasday JD, Sitrin RG. Dipyridamole stimulates urokinase production and suppresses procoagulant activity of rabbit alveolar macrophages: a possible mechanism of antithrombotic action. Blood. 1987;69:660-667.
Aktas B, Utz A, Hoening-Liedl P, Walter U, Deiger J. Dipyridamole enhances N/c GMF-mediated vasodilator — stimulated phosphoprotein phosphorylation and signaling in human platelets: in vivro and in vivo/ex vivo studies. Stroke. 2003;34:764-769. doi: 10.1161/01.str.0000056527.34434.59
Lip G, Kamath S, Hart R. ABC of antithrombotic therapy: Antithrombotic therapy for cerebrovascular disorders. BMJ. 2002;325:1161-1163. doi: 10.1136/bmj.325.7373.1161
Diener HC, Cunha L, Fordes C, Sivenius J, Smets P, Loventhal A. European Stroke Prevention Study 2 Dipiridamol and Acetylsalicyllic Acid in secondary prevention of stroke. J Neurologocal Sci. 1996;143:1-13. doi: 10.1016/s0022-510x(96)00308-5
Ringleb PA, Bousser MG, Ford G et al. The European Stroke Organization (ESO) Executive Committee and the ESO Writing Committee. Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack. 2008. (www.eso-stroke.org).
Halkes PH, van Gijn J, Kappelle LJ, Koudstaal PJ, Algra A. ESPRIT Study Group. Aspirin plus dipyridamole versus aspirin alone after cerebral ischemia of arterial origin (ESPRIT): randomized controlled trial. Lancet. 2006;367(9523):1665-1673. doi: 10.1016/s0140-6736(06)68734-5
Dickerson L, Carek P, Quattlebaum R. Prevention of recurrent ischemic stroke. Am Fam Physician. 2007;76(3):382-388.
Lee M, Saver JL, Hong SK, Rao NM, Wu YL, Ovbiagele B. Risk-benefit profile of long-term dual-versus singleantiplatelet therapy among patients with ischemic stroke: a systematic review and metaanalysis. Ann Intern Med. 2013;159(7):463-4670. doi: 10.7326/0003-4819-159-7-201310010-00006
Malloy R, Kanaan A, Silva M, Donovan J. Evaluation of antiplatelet agents for secondary prevention of stroke using mixed treatment comparison meta-analysis. Clin Ther. 2013;35(10):1490-1500. doi: 10.1016/j.clinthera.2013.09.004
Sharma A, Khanna D, Balakumar P. Low-dose dipyridamole treatment partially prevents diabetes mellitus-induced vascular endothelial and renal abnormalities in rats. Int J Cardiol. 2014;172(2):530-532. doi: 10.1016/j.ijcard.2014.01.053
Adams RJ, Albers G, Alberts MJ et al. American Heart Association; American Stroke Association. Update to the AHA/ASA recommendations for the prevention of stroke in patients with stroke and transient ischemic attack. Stroke. 2008;39(5):1647-1652. doi: 10.1161/strokeaha.107.189063
d͗ Esterre CD, Lee T-Y. Effect of dipyridamole during acute stroke: exploring antithrombosis and neuroprotective benefits. Annals of the York Academy of Sciences. 2010;71-75. doi: 10.1111/j.1749-6632.2010.05801.x
Tanashjan MM, Domashenko MA. Primenenie kurantila pri hronicheskom cerebrovaskuljarnom zabolevanii. Atmosfera. Nervnye bolezni. 2005;3:8-11. (In Russ.).

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