Lancet Neurology |。 2020 New Crown ravaged the world, a major clinical study of cerebrovascular disease

Lancet Neurology |。 Despite the global spread of the new crown in 2020 and the heavy clinical study of cerebrovascular disease in 2020, some progress has been made in various medical research, especially in stroke treatment and secondary prevention.
recent Lancet Neurology system combed through the heavyweight results of large-scale clinical studies in 2020.
2006 SPARCL study found that intensive statin therapy (atovastatin 80mg/d) is beneficial for stroke prevention.
nearly 15 years later, another similar RCT study ( Treat to Stroke to Target ) re-examines the prognostic effects of lowering LDL cholesterol on ishemoth stroke or transient isoemia attacks.
nearly 3,000 patients were randomly classified as low-density lipoproteins below 70 mg/dL (low target group) and 90-110 mg/dL (high target group).
patients assigned to the lower target group had a lower risk of major cardiovascular event complex primary endpoints than those in the higher target group during a 3.5-year follow-up period.
in both groups, more than 65 percent of the major cardiovascular events were is isoemia strokes or unexplained strokes, indicating an increased risk of stroke in the low-target group.
these test results confirm the results of SPARCL and emphasize that lipid management is a key therapeutic target for secondary atherosclerosis stroke prevention.
studies have shown that aspirin and clopidogrel double antiplate plate plate therapy is superior to aspirin monotherapy in patients with mild acute ischemia stroke or transient ischemia.
THALES study, which involved 414 sites in 28 countries, compared 24 hours after the onset of mild non-heart-based acute ischemic stroke or transient ischemic attacks: A: Tigrello (180mg on the first day, 90mg twice a day) and aspirin (300-325mg on the first day), 75-100mg per day B: Aspirin alone (300-325mg on the first day, 75-100mg daily).
results, compared to method B, the rate of ischemic stroke after treatment of method A was lower, and the bleeding event was more serious within 30 days of follow-up.
the benefits of short-term double antiplate plateroid therapy are reaffirmed by THALES, any additional value of replacing clopidogrel with tegrelo remains uncertain.
ischemic stroke, endovascular thrombosis is also a very effective treatment.
In a study published in the New England Journal of Medicine, led by the Second Army Changhai Hospital, they found that in patients with acute ischemic stroke with large vascular occysts in China, thrombosis alone was no less functional than intravenous intravenous atipase and thrombosis removal within 4.5 hours of the onset of symptoms.
although in-vascular thrombosis has significantly improved functional outcomes in patients with acute ischemic stroke, many individuals treated have died or suffered severe disabilities.
, some experiments have studied the functional prognosis of in-vascular thrombosis removal.
in the ESCAPE-NA1 study, the researchers looked at Neni peptide, a 20 carbon fourpeptide that interferes with the synhapine post-density protein 95 and is an effective neuroproteant in the preclinical stroke ischemic-refilling model.
the trial, they assessed the effectiveness and safety of neuropeptides in ischemic-refilling after rapid thrombosis removal in blood vessels in patients with acute ischemic stroke.
results found that nellide did not improve the functional prognosis of patients after in-vascular coagulase excision compared to patients treated with a placebo.
Amarenco P, Kim JS, Labreuche J, et al. A comparison of two LDL cholesterol targets after ischemic stroke. N Engl J Med 2020; 382: 9–19.Katsanos AH, Hart RG. New horizons in pharmacologic therapy for secondary stroke prevention. JAMA Neurol 2020; 77: 1308–17.Yang P, Zhang Y, Zhang L, et al. Endovascular thrombectomy with or without intravenous alteplase in acute stroke. N Engl J Med 2020; 382: 1981–93.Hill MD, Goyal M, Menon BK, et al. Efficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): a multicentre, double-blind, randomised controlled trial. Lancet 2020; 395: 878-87. Cai Mengfei Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Originals" are owned by Mets Medical and are not licensed and may not be reproduced by any media, website or individual, and shall be reproduced with the words "Source: Mets Medicine".
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