Angiotensin-converting enzyme inhibitors will help in improving stroke outcome if given immediately after stroke

Mv, Padma

doi:10.4103/0972-2327.70869

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…Angiotensin II acting through its receptors has vasopressor, proinflammatory, and procoagulant effects [ 9 ]. Inhibitors of angiotensin II receptors have been shown to have antihypertensive as well as neuroprotective effects [ 16 ]. ACE2 counteracts the action of ACE1 by converting angiotensin II to angiotensin (1–7), a vasodilator and anti-inflammatory molecule, and converting angiotensin I to angiotensin (1–9), which is further converted to angiotensin (1–7) [ 17 ].…”

Section: Pathogenesis Of Ischemic Stroke In Covid-19mentioning

confidence: 99%

Acute Ischemic Stroke in COVID-19: Putative Mechanisms, Clinical Characteristics, and Management

Ojo

Balogun

Idowu

2020

Neurology Research International

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The emergence and spread of the highly contagious novel coronavirus disease (COVID-19) have triggered the greatest public health challenge of the last century. Aside from being a primary respiratory disease, acute ischemic stroke has emerged as a complication of the disease. While current evidence shows COVID-19 could cause ischemic stroke especially in severe disease, there are similarities in the risk factors for severe COVID-19 as well as ischemic stroke, underscoring the complex relationship between these two conditions. The pandemic has created challenges for acute stroke care. Rapid assessment and time-sensitive interventions required for optimum outcomes in acute stroke care have been complicated by COVID-19 due to the need for disease transmission preventive measures. The purpose of this article is to explore the putative mechanisms of ischemic stroke in COVID-19 and the clinical characteristics of COVID-19 patients who develop ischemic stroke. In addition, we discuss the challenges of managing acute ischemic stroke in the setting of COVID-19 and review current management guidelines. We also highlighted potential areas for future research.

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Section: Pathogenesis Of Ischemic Stroke In Covid-19mentioning

confidence: 99%

Acute Ischemic Stroke in COVID-19: Putative Mechanisms, Clinical Characteristics, and Management

Ojo

Balogun

Idowu

2020

Neurology Research International

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“…The neuroprotective benefits of the preoperative administration of beta-blockers and statins in cardiac surgery are not definitive, and further studies are warranted [ 3 , 46 ]. Also, angiotensin-converting enzyme inhibitors (ACEI) are capable neuroprotectants that warrant further investigation in the setting of cardiac surgery on their effects as pre- and postoperative therapy to mitigate against POCD, strokes, ischaemic events, and mortality [ 47 ].…”

Section: Neuroprotection Interventionsmentioning

confidence: 99%

Contemporary Neuroprotection Strategies during Cardiac Surgery: State of the Art Review

Chakane

Mogane

Moutlana

et al. 2021

IJERPH

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Open-heart surgery is the leading cause of neuronal injury in the perioperative state, with some patients complicating with cerebrovascular accidents and delirium. Neurological fallout places an immense burden on the psychological well-being of the person affected, their family, and the healthcare system. Several randomised control trials (RCTs) have attempted to identify therapeutic and interventional strategies that reduce the morbidity and mortality rate in patients that experience perioperative neurological complications. However, there is still no consensus on the best strategy that yields improved patient outcomes, such that standardised neuroprotection protocols do not exist in a significant number of anaesthesia departments. This review aims to discuss contemporary evidence for preventing and managing risk factors for neuronal injury, mechanisms of injury, and neuroprotection interventions that lead to improved patient outcomes. Furthermore, a summary of existing RCTs and large observational studies are examined to determine which strategies are supported by science and which lack definitive evidence. We have established that the overall evidence for pharmacological neuroprotection is weak. Most neuroprotective strategies are based on animal studies, which cannot be fully extrapolated to the human population, and there is still no consensus on the optimal neuroprotective strategies for patients undergoing cardiac surgery. Large multicenter studies using universal standardised neurological fallout definitions are still required to evaluate the beneficial effects of the existing neuroprotective techniques.

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“…Similar to aspirin, angiotensin converting enzyme (ACE) inhibitors can act on thrombus formation through fibrinolysis, plaque stabilization, and collateral circulation enhancement in the same way aspirin was shown to improve stoke outcomes [66]. They are another medication used to reduce blood pressure whose use as a neuroprotectant is being explored.…”

Section: Pharmacological Neuroprotection In Cardiac Surgerymentioning

confidence: 99%

Neuroprotection against stroke and encephalopathy after cardiac surgery

Jovin

Katlaps

Ellis

et al. 2019

Interventional Medicine and Applied Science

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Cerebral ischemia in the perioperative period is a major risk factor for stroke, encephalopathy, and cognitive decline after cardiothoracic surgery. After coronary artery bypass grafting, both stroke and encephalopathy can result in poor patient outcomes and increased mortality. Neuroprotection aims to lessen the severity and occurrence of further injury mediated by stroke and encephalopathy and to aid the recovery of conditions already present. Several pharmacological and non-pharmacological methods of neuroprotection have been investigated in experimental studies and in animal models, and, although some have shown effectiveness in protection of the central nervous system, for most, clinical research is lacking or did not show the expected results. This review summarizes the value and need for neuroprotection in the context of cardiothoracic surgery and examines the use and effectiveness of several agents and methods with an emphasis on clinical trials and clinically relevant neuroprotectants.

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Angiotensin-converting enzyme inhibitors will help in improving stroke outcome if given immediately after stroke

Cited by 6 publications

References 24 publications

Acute Ischemic Stroke in COVID-19: Putative Mechanisms, Clinical Characteristics, and Management

Acute Ischemic Stroke in COVID-19: Putative Mechanisms, Clinical Characteristics, and Management

Contemporary Neuroprotection Strategies during Cardiac Surgery: State of the Art Review

Neuroprotection against stroke and encephalopathy after cardiac surgery

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