title: Current and future perspectives on the treatment of cerebral ischemia.
abstract: After heart disease and combined forms of cancer, stroke is the leading cause of death in the United States. Currently, tissue-plasminogen activator (tPA) thrombolysis is the only thrombolytic therapy that has been shown to improve patient outcome. Presently, the only antithrombotic drug treatment that has proven effective at improving acute ischemic stroke patient outcome is aspirin administration. Despite these studies, no clinical trials have yet demonstrated a reliably effective pharmacological treatment. Areas covered: We conducted a search of recent drug studies for ischemic stroke on clinicaltrials.gov in addition to a literature search for acute ischemic stroke therapy using PubMed. This review details our findings of recent advancements in the pharmacological treatment of acute ischemic stroke. Expert commentary: We concluded that recent attempts to establish new pharmacological treatment protocols for acute ischemic stroke have had limited success, but many Phase III and Phase IV clinical trials demonstrate promise. Moreover, several studies have demonstrated the efficacy of dual-antiplatelet therapies at reducing risk of secondary stroke. Studies for novel therapeutic targets for neuroprotection have been largely unsuccessful. Some trials had positive results; however, there is much room for improvement and other studies show promise in their preliminary stages.
authors.affiliation: a Department of Neurological Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Brandon R
authors.initials: BR
authors.lastname: Christophe
authors.affiliation: a Department of Neurological Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Shyle H
authors.initials: SH
authors.lastname: Mehta
authors.affiliation: a Department of Neurological Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Andrew L A
authors.initials: AL
authors.lastname: Garton
authors.affiliation: a Department of Neurological Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sisti
authors.affiliation: a Department of Neurological Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: E Sander
authors.initials: ES
authors.lastname: Connolly
mesh_terms: D001241:Aspirin / Q000627:therapeutic use; D002545:Brain Ischemia / Q000188:drug therapy*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D001241:Aspirin
keywords: Ischemia; antithrombotic; neuroprotection; pharmacotherapy; reperfusion; stroke; thrombolysis