Combined Neuroprotective Modalities Coupled with Thrombolysis in Acute Ischemic Stroke: A Pilot Study of Caffeinol and Mild Hypothermia

Journal of Stroke and Cerebrovascular Diseases

Volumn 18, Issue 2, 2009, Pages 86-96

  Martin Schild, Sheryl ^a   Hallevi, Hen ^a   Shaltoni, Hashem ^a   Barreto, Andrew D ^a   Gonzales, Nicole R ^a   Aronowski, Jarek ^a   Savitz, Sean I ^a   Grotta, James C ^a  

^a UNIVERSITY OF TEXAS MEDICAL SCHOOL   (United States)

Author keywords

Acute ischemic stroke; feasibility; hypothermia; neuroprotection; safety

Indexed keywords

ALCOHOL; BUSPIRONE; CAFFEINE; CAFFEINOL; CLOPIDOGREL; MAGNESIUM SULFATE; PETHIDINE; SODIUM CHLORIDE; TISSUE PLASMINOGEN ACTIVATOR; UNCLASSIFIED DRUG;

ABSENCE OF SIDE EFFECTS; ACUTE DISEASE; ADULT; AGED; ANASTOMOSIS; ARTERY OCCLUSION; ARTICLE; BLOOD CLOT LYSIS; BODY TEMPERATURE MONITORING; BRADYCARDIA; BRAIN EDEMA; BRAIN HEMORRHAGE; BRAIN VENTRICULITIS; CEREBROVASCULAR ACCIDENT; CLINICAL ARTICLE; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; CONTROLLED STUDY; COOLING; DEEP VEIN THROMBOSIS; DEVICE; DRUG BLOOD LEVEL; DRUG DOSE INCREASE; DRUG DOSE REDUCTION; DRUG SAFETY; DRUG TOLERABILITY; ECCHYMOSIS; FEASIBILITY STUDY; FEMALE; HEART ARREST; HUMAN; HYPOTHERMIA; LIMB ISCHEMIA; LOADING DRUG DOSE; MALE; MORTALITY; NATIONAL INSTITUTES OF HEALTH STROKE SCALE; NEUROPROTECTION; PHASE 1 CLINICAL TRIAL; PLASMAPHERESIS; PNEUMONIA; PRIORITY JOURNAL; RESPIRATORY DRIVE; SEDATION; SHIVERING; SIDE EFFECT; SKIN INFECTION; THROMBOTIC THROMBOCYTOPENIC PURPURA; TREATMENT OUTCOME; URINARY TRACT INFECTION; WARMING;

ACUTE DISEASE; ADJUVANTS, ANESTHESIA; ADULT; AGED; AGED, 80 AND OVER; ANTI-ANXIETY AGENTS; BRAIN ISCHEMIA; BUSPIRONE; CAFFEINE; DRUG COMBINATIONS; ETHANOL; FEMALE; FIBRINOLYTIC AGENTS; HUMANS; HYPOTHERMIA, INDUCED; MALE; MEPERIDINE; MIDDLE AGED; NEUROPROTECTIVE AGENTS; PILOT PROJECTS; SHIVERING; STROKE; THROMBOLYTIC THERAPY; TISSUE PLASMINOGEN ACTIVATOR; TREATMENT OUTCOME;

EID: 60949087646     PISSN: 10523057     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jstrokecerebrovasdis.2008.09.015     Document Type: Article

References (24)

1. De Keyser J., Uyttenboogaart M., Koch M.W., et al. Neuroprotection in acute ischemic stroke. Acta Neurol Belg 105 (2005) 144-148
2. Young A.R., Ali C., Duretete A., et al. Neuroprotection and stroke: Time for a compromise. J Neurochem 103 (2007) 1302-1309
3. Cheng Y.D., Al-Khoury L., and Zivin J.A. Neuroprotection for ischemic stroke: Two decades of success and failure. NeuroRx 1 (2004) 36-45
4. Wahlgren N.G., and Ahmed N. Neuroprotection in cerebral ischemia: Facts and fancies-the need for new approaches. Cerebrovasc Dis 17 Suppl (2004) 153-166
5. Fredholm B.B., Battig K., Holmen J., et al. Actions of caffeine in the brain with special reference to factors that contribute to its widespread use. Pharmacol Rev 51 (1999) 83-133
6. Fredholm B.B. Astra award lecture: Adenosine, adenosine receptors and the actions of caffeine. Pharmacol Toxicol 76 (1995) 93-101
7. Barone J.J., and Roberts H.R. Caffeine consumption. Food Chem Toxicol 34 (1996) 119-129
8. Lovinger D.M., White G., and Weight F.F. Ethanol inhibits NMDA-activated ion current in hippocampal neurons. Science 243 (1989) 1721-1724
9. Chandler L.J., Sumners C., and Crews F.T. Ethanol inhibits NMDA receptor-mediated excitotoxicity in rat primary neuronal cultures. Alcohol Clin Exp Res 17 (1993) 54-60
10. Ruf J.C. Alcohol, wine and platelet function. Biol Res 37 (2004) 209-215
11. Aronowski J., Strong R., Shirzadi A., et al. Ethanol plus caffeine (caffeinol) for treatment of ischemic stroke: Preclinical experience. Stroke 34 (2003) 1246-1251
12. Belayev L., Khoutorova L., Zhang Y., et al. Caffeinol confers cortical but not subcortical neuroprotection after transient focal cerebral ischemia in rats. Brain Res 1008 (2004) 278-283
13. Lapchak P.A., Song D., Wei J., et al. Pharmacology of caffeinol in embolized rabbits: Clinical rating scores and intracerebral hemorrhage incidence. Exp Neurol 188 (2004) 286-291
14. Piriyawat P., Labiche L.A., Burgin W.S., et al. Pilot dose-escalation study of caffeine plus ethanol (caffeinol) in acute ischemic stroke. Stroke 34 (2003) 1242-1245
15. Martin-Schild S., Morales M.M., Barreto A.D., et al. Combined therapy of IV t-PA with caffeinol in acute ischemic stroke. Stroke 39 (2008) 593
16. Reith J., Jorgensen H.S., Pedersen P.M., et al. Body temperature in acute stroke: Relation to stroke severity, infarct size, mortality, and outcome. Lancet 347 (1996) 422-425
17. Krieger D.W., and Yenari M.A. Therapeutic hypothermia for acute ischemic stroke: What do laboratory studies teach us?. Stroke 35 (2004) 1482-1489
18. Holzer M., Behringer W., Schorkhuber W., et al. Mild hypothermia and outcome after CPR: Hypothermia for cardiac arrest (HACA) study group. Acta Anaesthesiol Scand 111 (1997) 55-58
19. Bernard S.A., Jones B.M., and Horne M.K. Clinical trial of induced hypothermia in comatose survivors of out-of-hospital cardiac arrest. Ann Emerg Med 30 (1997) 146-153
20. Lyden P.D., Allgren R.L., Ng K., et al. Intravascular cooling in the treatment of stroke (ICTuS): Early clinical experience. J Stroke Cerebrovasc Dis 14 (2005) 107-114
21. Adams Jr. H.P., del Zoppo G., Alberts M.J., et al. . Guidelines for the early management of adults with ischemic stroke: A guideline from the American Heart Association/American Stroke Association stroke council, clinical cardiology council, cardiovascular radiology and intervention council, and the atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups; the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 38 (2007) 1655-1711
22. Hacke W., Kaste M., Fleschi C., et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study investigators. Lancet 352 (1998) 1245-1251
23. Strong R., Grotta J.C., and Aronowski J. Combination of low dose ethanol and caffeine protects brain from damage produced by focal ischemia in rats. Neuropharmacology 39 (2000) 515-522
24. Hemmen T.M., and Lyden P.D. Induced hypothermia for acute stroke. Stroke 38 Suppl (2007) 794-799