The effect of the use of Mexidol during the "therapeutic window" of ischemic stroke on the effectiveness of intravenous thrombolytic therapy

Authors:
K.S. Knny, T.V. Demin, L.B. Adaeva

GAUZ "Interregional Clinical and Diagnostic Center", Kazan, Russia

Place of publication:
“Neurology, neuropsychiatry, psychosomatics”, 2018; 10 (3): 86–90

Resume:
The purpose of the study is to assess the influence of intravenous administration of Mexidol during the “therapeutic window” on the effectiveness of intravenous thrombolytic therapy (TLT). Patients and methods. A retrospective study includes 123 patients with an ischemic stroke (AI) who conducted intravenous TLT in the conditions of the vascular centers of the Republic of Tatarstan. To assess the dynamics of neurological status, they used the scale of the severity of the National Institute of Health (National Stroke Scale (Nihss). Depending on the initial severity of the neurological deficiency, all patients were divided into three subgroups: with mild severity (Lee) and an assessment by NIHSS at admission <8 points; with moderate severity (si) - with an assessment> 8 and <16 points; With heavy AI (TI) - with an assessment> 16 points. X -ray computed tomography was performed by all patients at the time of admission, 24 hours after the TLT, as well as with a deterioration in the condition. Results. The use of Mexidol at the prehospital stage, followed by TLT in patients with AI positively affects the regression of neurological deficiency, regardless of the severity of the disease. Reliable differences in the degree of regression of the neurological deficiency according to NIHSS 24 hours and 10 days after receipt of patients with TI who were introduced by Mexidol at the prehospital stage were revealed and who did not receive this drug before the implementation of TLT. The use of Mexidol before TLT promotes greater regression of neurological deficiency. A lower frequency of development of hemorrhagic transformations has been established in patients who received Mexidol at the prehospital stage, in comparison with patients who did not use this drug. Conclusion. The data obtained demonstrate the positive effect of Mexidol on the effectiveness and safety of TLT in patients with AI. Keywords: ethylmethylhydroxypyridine succinate; intravenous thrombolytic therapy; ischemic stroke; Neuroprotective therapy.