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(Stroke. 2001;32:2635.)
© 2001 American Heart Association, Inc.

Original Contributions

Extension of the Therapeutic Window for Recombinant Tissue Plasminogen Activator With Argatroban in a Rat Model of Embolic Stroke

Daniel C. Morris, MD; Li Zhang, MD; Zheng Gang Zhang, MD, PhD; Mei Lu, PhD; Kurt L. Berens, BA; Philip M. Brown, MD Michael Chopp, PhD

From the Departments of Emergency Medicine (D.C.M.), Neurology (L.Z., Z.G.Z., M.C.), and Biostatistics and Research Epidemiology (M.L.), Henry Ford Health Sciences Center, Detroit, Mich; Texas Biotechnology Corporation (K.L.B.), Houston, Tex; and Physics Department (M.C.), Oakland University, Rochester, Mich.

Correspondence to Michael Chopp, PhD, Neurology Department, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202. E-mail chopp{at}neuro.hfh.edu

Background and Purpose—— Argatroban, a specific thrombin inhibitor, has been shown to reduce ischemic lesion size after focal cerebral ischemia in rats. In addition, recombinant tissue plasminogen activator (rtPA) has been shown to reduce ischemic lesion size in both rats and humans if given within 3 hours of symptom onset. We tested the hypothesis that the administration of argatroban with rtPA could extend the treatment window of stroke to 4 hours without increasing gross cerebral hemorrhage rates or reducing efficacy.

Methods—— Male Wistar rats were subjected to middle cerebral artery (MCA) occlusion by a single fibrin-rich clot. After embolization, rats were administered argatroban at the following dose levels: 2.08, 6.25, and 18.75 µg · kg^-1 · min^-1. In a second experiment, rats received argatroban (6.25 µg · kg^-1 · min^-1) or argatroban in combination with rtPA 4 hours after MCA occlusion. Tissue sections were then analyzed for lesion volume, gross hemorrhage and fibrin deposition.

Results—— The 6.25 µg · kg^-1 · min^-1 dose demonstrated a significant reduction (P<0.05) in lesion volume after 48 hours (27.2±6.3%) compared with controls (35.3±3.7%). A significant reduction (P<0.05) in lesion volume was observed in the argatroban-plus-rtPA group (17.1±10.4%) compared with controls (35.3±3.7%). No increase in hemorrhagic transformation was observed. Fibrin deposition in the ipsilateral cortical microvasculature was significantly decreased in the 4-hour combination argatroban-plus-rtPA group compared with the controls (P<0.05).

Conclusions—— This study demonstrates that the combination of argatroban and rtPA extends the window of opportunity for treatment of stroke to 4 hours without increasing hemorrhagic transformation.

Key Words: cerebral ischemia • stroke • thrombin • tissue plasminogen activator • rats

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