Page 542

Karger_ESC London_2013

22. European Stroke Conference 479 Experimental studies THE ROLE OF ADJUVANT VINPOCETINE THERAPY IN ASPIRIN-TREATED CERE-BROVASCULAR PATIENTS L. Szapary1, P. Csecsei2, J. Papp3, P. Kenyeres4, G. Kesmarky5, M. Rabai6, G. Feher7, K. Toth8 Department of Neurology University of Pecs, School of Medicine, Pecs, HUNGARY1, Depart-ment of Neurology University of Pecs, School of Medicine, Pecs, HUNGARY2, First Department of Medicine, Division of Cardiology, University of Pecs, School of Medicine, Pecs, HUNGARY3, First Department of Medicine, Division of Cardiology, University of Pecs, School of Medicine, Pecs, HUNGARY4, First Department of Medicine, Division of Cardiology, University of Pecs, School of Medicine, Pecs, HUNGARY5, First Department of Medicine, Division of Cardiology, University of Pecs, School of Medicine, Pecs, HUNGARY6, Department of Neurology University of Pecs, School of Medicine, Pecs, HUNGARY7, First Department of Medicine, Division of Cardiology, University of Pecs, School of Medicine, Pecs, HUNGARY8 Introduction: The term aspirin resistance has been applied to interindividual variability in platelet reactivity during aspirin therapy or to thrombosis despite appropriate therapy. This phenomenon has been the subject of intense investigation for its association with poor cardiovascular outcomes, but despite of intensive research the treatment of impaired platelets’ response is still unkown. Theaim of our study was to detect the benefitial effects of adjuvant vinpocetine therapy in aspirin-treated cere-brovascular 542 © 2013 S. Karger AG, Basel Scientific Programme patients. Patients and methods: The study investigates the endothel dysfunction, hemorheological and ago-nist- induced platelet aggregtion changes in 20 patients in the chronic stage of ischemic cardiovascu-lar disease after administration of vinpocetine. All patients received a high dose of intravenous VP in doses gradually increased to l mg/kg/day. Hemorheological parameters (hematocrit, plasma fibrin-ogen, whole blood viscosity, red blood cell aggregation and deformability), endothel dysfunction markers (von Willebrand factor, soluble P-selectin) and agonist (collagen, epineprine, arachidonic acid and adenosine-diphosphate)-induced platelet aggregation values were evaluated at baseline, on the 7th and on the 30th day. Results:Seven days of high-dose parenteral vinpocetine infusion significantly decreased von Wille-brand factor levels 1.649 ± 0.198 NU/ml vs. 1.558 ± 0.140 NU/ml, p = 0.011) and it still remained significant after 30 days (1.649 ± 0.198 NU/ml vs. 1.509 ± 0.126 NU/ml, p=0.001) Red blood cell deformability was significantly decreased at the end of the study (0.563 ± 0.1 vs 0.558 ± 0.008, p=0.036). There were no statistically significant differences among the other examined hemorheo-logical parameters. Platelet aggregation values were not significantly changed during the examina-tion period, although there was a decreasing tendency seeing arachidonic acid (32.47 ± 7.28 % vs 21.89 ± 6.84, p = 0.1). Conclusion: Vinpocetine partially by its benefitial hemorheological and endothel-dysfunction im-proving profile may help to overcome aspirin resistance. Further examinations based on larger popu-lations are required. 480 Experimental studies Angiotensin type-1 receptor blockage is associated with brain protection after cerebral infarct in experimental animal model B. Rodríguez-Frutos1, M. Gutiérrez-Fernández2, J. Ramos-Cejudo3, B. Fuentes4, L. Otero-Ortega5, E. Díez-Tejedor6 Neurology Department, Neuroscience and Cerebrovascular Research Laboratory, La Paz University Hospital, IdiPAZ, UAM, Madrid, Spain., Madrid, SPAIN1, Neurology Department, Neuroscience and Cerebrovascular Research Laboratory, La Paz University Hospital, IdiPAZ, UAM, Madrid, Spain., Madrid, SPAIN2, Neurology Department, Neuroscience and Cerebrovascular Research Laboratory, La Paz University Hospital, IdiPAZ, UAM, Madrid, Spain., Madrid, SPAIN3, Neurology Department, Neuroscience and Cerebrovascular Research Laboratory, La Paz University Hospital, IdiPAZ, UAM, Madrid, Spain., Madrid, SPAIN4, Neurology Department, Neuroscience and Cerebrovascular Research Laboratory, La Paz University Hospital, IdiPAZ, UAM, Madrid, Spain., Madrid, SPAIN5, Neurology Department, Neuroscience and Cerebrovascular Research Labo-ratory, La Paz University Hospital, IdiPAZ, UAM, Madrid, Spain., Madrid, SPAIN6 Background: The protective properties of angiotensin type-1 receptor blockade have been reported by improved cerebral blood flow, the restoration of endothelial nitric oxide synthase, decreased in-flammation, or stimulation of the angiotensin type-2 receptor. Olmesartan could be involucrate in brain protection and repair. Aim: To analyze olmesartan effects (administer before or after of perma-nent middle cerebral artery occlusion (pMCAO)) on functional recovery associated with brain pro-tection and repair after pMCAO in rats. Methods: Male rats distributed into 4 groups (n=4): 1-Sham; 2- Control: surgery + infarct; 3- Olme-sartan before pMCAO (olmesartan (10mg/kg) for 7 days before infarct+surgery+infarct+olmesartan (10mg/kg per day for 14 days)); 4- Olmesartan after pMCAO (surgery+infarct+olmesartan (10mg/ kg per day for 14 days). We analyzed: functional recovery (Rogers scale), lesion volume by mag-netic resonance imaging (MRI) and by hematoxyline-eosin (H&E), cell death by TUNEL, anti-in-flammatory cytokines (IL-4,IL-10) by ELISA, repair markers: VEGF, GFAP and Synaptophysin by western blot and immunofluorescence. Rats were sacrificed at day 14. Results: Olmesartan groups showed a significant functional recovery at 14 days (p =0,030) in com-parison with Control group. Although no effect on lesion volume measured by MRI was observed, the H&E analysis showed a significant reduction of lesion volume both in Olmesartan (p=0,006). Levels of IL-4 and IL-10, did not showed significant differences between groups. Olmesartan before (p=0,022) and after pMCAO (p=0.011) groups showed a decrease in cell death compared to Control. We did not observe significant differences in VEGF,GFAP and synapthophysin expression between Control group and treated groups. Conclusions: The administration of Olmesartan, before and after stroke in rats, shows brain protec-tion effects (decrease lesion size (H&E) and cell death) but we could not found an effect on repair markers.


Karger_ESC London_2013
To see the actual publication please follow the link above