title: Administration of free radical scavenger edaravone associated with higher frequency of hemorrhagic transformation in patients with cardiogenic embolism.
abstract: Free radicals are known to activate coagulation and inhibit fibrinolysis. Edaravone, a free radical scavenger, protects vascular endothelial cells and neurons during acute brain ischemia in in vitro models. Hemorrhagic transformation and treatment outcomes were retrospectively examined in 76 patients with acute cardiogenic embolism treated with edaravone in addition to routine treatment within 24 hours of the onset of symptoms. Hemorrhagic transformation was categorized according to European Cooperative Acute Stroke Study-II. Patient characteristics were also evaluated, including evidence of hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease, history of smoking, National Institutes of Health Stroke Scale on arrival, and modified Rankin scale at 3 months post-onset. Edaravone administration was one of the factors that contributed to increased frequency of hemorrhagic transformation, but had showed no significant relationship with the outcome. The present study showed that edaravone administration increased the frequency of hemorrhagic transformation with heparin in patients with cardiogenic embolism. Free radical scavenging may have promoted the coagulating conditions. Edaravone administration may allow reduction of the dose of heparin and tissue plasminogen activator in patients with acute ischemic stroke.
authors.affiliation: Neurological Institute, Nippon Medical School Chiba-Hokusoh Hospital, Chiba, Japan. mishina@nms.ac.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mishina
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Komaba
authors.forename: Shiro
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Shushi
authors.initials: S
authors.lastname: Kominami
authors.forename: Takaharu
authors.initials: T
authors.lastname: Fukuchi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Mizunari
authors.forename: Akira
authors.initials: A
authors.lastname: Teramoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000983:Antipyrine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis; D004305:Dose-Response Relationship, Drug; D000077553:Edaravone; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000009:adverse effects*; D006331:Heart Diseases / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007262:Infusions, Intravenous; D020766:Intracranial Embolism / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D016166:Free Radical Scavengers; D000077553:Edaravone; D000983:Antipyrine