Neuroprotective effects of oral metformin before stroke on cerebral small-vessel disease

Akiyama, Natsuki; Yamashiro, Takayuki; Ninomiya, Itaru; Uemura, Masahiro; Hattori, Yorito; Ihara, Masafumi; Onodera, Osamu; Kanazawa, Masato

doi:10.1016/j.jns.2023.122812

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…Regarding stroke, there are data suggesting a beneficial effect of metformin, particularly if there is a sustained use pre-event that is maintained afterward [95]. Taking metformin prior to stroke seems to be associated with lower stroke severity and better functional outcomes in patients with small-vessel disease [96].…”

Section: What About "Older" Pharmacological Options?mentioning

confidence: 99%

Diabetes and Stroke: Impact of Novel Therapies for the Treatment of Type 2 Diabetes Mellitus

Vieira,

Carvalho,

Saraiva

et al. 2024

Biomedicines

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Type 2 diabetes mellitus (T2DM) is a significant risk factor for stroke. Nevertheless, the evidence supporting stringent glycemic control to reduce macrovascular complications, particularly stroke, is not as clear as for microvascular complications. Presently, risk reduction strategies are based on controlling multiple risk factors, including hypertension, dyslipidemia, glycemia, smoking, and weight. Since 2008, new pharmacological therapies for treating T2DM have been required to undergo trials to ensure their cardiovascular safety. Remarkably, several novel therapies have exhibited protective effects against the combined endpoint of major cardiovascular events. Evidence from these trials, with stroke as a secondary endpoint, along with real-world data, suggests potential benefits in stroke prevention, particularly with glucagon-like peptide 1 receptor agonists. Conversely, the data on sodium–glucose cotransporter type 2 inhibitors remains more controversial. Dipeptidyl peptidase 4 inhibitors appear neutral in stroke prevention. More recent pharmacological therapies still lack significant data on this particular outcome. This article provides a comprehensive review of the evidence on the most recent T2DM therapies for stroke prevention and their impact on clinical practice.

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Section: What About "Older" Pharmacological Options?mentioning

confidence: 99%