Stroke. 2002;33:862-875
doi: 10.1161/hs0302.103657
doi: 10.1161/hs0302.103657
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(Stroke. 2002;33:862.)
© 2002 American Heart Association, Inc.
Comments, Opinions, and Reviews |
Stroke Prevention Therapy Beyond Antithrombotics: Unifying Mechanisms in Ischemic Stroke Pathogenesis and Implications for Therapy
An Invited Review
From the Department of Neurologic Sciences, Rush Medical College, Chicago, Ill.
Correspondence to Philip B. Gorelick, MD, MPH, FACP, Center for Stroke Research, 1645 West Jackson, Suite 400, Chicago, IL 60612. E-mail Philip_B_Gorelick{at}rush.edu
Background— It is estimated that about half of cardiovascular disease risk is explained by conventional risk factors. The realization that atherosclerosis is an inflammatory disease has led to a search for new stroke and cardiovascular disease risk factors and treatments. As such, the vulnerable atherosclerotic plaque has become the main focus for new medical strategies for plaque stabilization and stroke prevention.
Summary of Review— In this invited review, I discuss inflammation as a possible risk factor for stroke, unifying mechanisms in ischemic stroke pathogenesis, and new avenues for stroke prevention—statin agents, angiotensin-converting enzyme inhibitors, and vitamins. These new stroke prevention therapies may help to reduce inflammation, serve to stabilize the atherosclerotic plaque, or act by other protective mechanisms.
Conclusion— Beyond the traditional antithrombotic agents, statin agents, angiotensin-converting enzyme inhibitors, and vitamins may prove to be important additions to our armamentarium for stroke prevention.
Key Words: angiotensin-converting enzyme inhibitors (ACE-I) • homocysteine • infection • inflammation • statin agents • stroke prevention
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