Lucke-Wold Brandon P, DiPasquale Kenneth, Logsdon Aric F, Nguyen Linda, Lucke-Wold A Noelle, Turner Ryan C, Huber Jason D, Rosen Charles L
Department of Neurosurgery, West Virginia University, School of Medicine, Morgantown, West Virginia; The Center for Neuroscience, West Virginia University, School of Medicine, Morgantown, West Virginia.
The Center for Neuroscience, West Virginia University, School of Medicine, Morgantown, West Virginia; Department of Basic Pharmaceutical Sciences, West Virginia University, School of Pharmacy, Morgantown, West Virginia.
Am Med Stud Res J. 2014 Spring;1(1):29-38. doi: 10.15422/amsrj.2014.05.004.
Ischemic stroke represents a leading cause of death worldwide and the leading cause of disability in the United States. Greater than 8% of all deaths are attributed to ischemic stroke. This rate is consistent with the heightened burden of cardiovascular disease deaths. Treatments for acute ischemic stroke remain limited to tissue plasminogen activator and mechanical thrombolysis, both of which require significant medical expertise and can only be applied to a select number of patients based on time of presentation, imaging, and absence of contraindications. Over 1,000 compounds that were successful in treating ischemic stroke in animal models have failed to correlate to success in clinical trials. The search for alternative treatments is ongoing, drawing greater attention to the importance of preclinical models that more accurately represent the clinical population through incorporation of common risk factors. This work reviews the contribution of these commonly observed risk factors in the clinical population highlighting both the pathophysiology as well as current clinical diagnosis and treatment standards. We also highlight future potential therapeutic targets, areas requiring further investigation, and recent changes in best-practice clinical care.
缺血性中风是全球主要的死亡原因之一，也是美国导致残疾的主要原因。超过8%的死亡归因于缺血性中风。这一比例与心血管疾病死亡负担的增加相一致。急性缺血性中风的治疗方法仍然局限于组织纤溶酶原激活剂和机械溶栓，这两种方法都需要专业的医学知识，并且只能根据就诊时间、影像学检查和无禁忌症等因素应用于少数患者。在动物模型中成功治疗缺血性中风的1000多种化合物在临床试验中均未取得成功。寻找替代治疗方法的工作仍在进行，这使得人们更加关注临床前模型的重要性，即通过纳入常见风险因素更准确地代表临床人群。本文综述了这些临床人群中常见风险因素的作用，强调了病理生理学以及当前的临床诊断和治疗标准。我们还强调了未来潜在的治疗靶点、需要进一步研究的领域以及最佳临床护理实践的最新变化。
