Medication may promote opening of arteries following stroke

A medication known as argatroban, when combined with another drug already used in the treatment of stroke patients, may help restore the flow of blood through blocked arteries, according to a preliminary study in the August issue of Archives of Neurology, one of the JAMA/Archives journals.

Ischemic stroke, the most common type of stroke, generally occurs when a blood clot lodges in an artery, blocking blood flow to the brain. Some patients with ischemic stroke are treated quickly with intravenous recombinant tissue plasminogen activator (rtPA), which works to help dissolve the clot and reopen the artery. However, some patients do not respond to rtPA alone, according to background information in the article. In animals, argatroban--which blocks the action of chemicals that clot the blood--has been shown to work with rtPA, increasing blood flow, speeding the opening of blood vessels and preventing recurring blockages. Argatroban is approved for use in patients with heart attacks to help prevent clots but has not been tested in human stroke victims.

Rebecca M. Sugg, M.D., University of TexasHouston Medical School, and colleagues evaluated the safety and efficacy of the drug combination in 15 stroke patients (10 men and five women, average age 61 years) who had blockages in the cerebral arteries, major blood vessels leading to the brain. Patients received the standard dose of rtPA intravenously an average of 118 minutes after their symptoms began, with the initial dose of the drug administered in one minute and the rest infused over the period of an hour. Within one hour of rtPA treatment (an average of 172 minutes after symptoms began), the patients received a large dose of argatroban followed by a continuous 48-hour infusion. Patients were watched closely for signs of excessive bleeding (hemorrhage), the most common risk associated with drugs that prevent clotting; all but one participant, who showed initial signs of hemorrhage, received

Contact: Deborah Mann Lake
JAMA and Archives Journals

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