Effect of mexidol on the efficiency of intravenous thrombolytic therapy for ischemic stroke during the therapeutic window

Knni K.S., Dyomin T.V., Adeeva L.B.
Interregional Clinical and Diagnostic Center, Kazan, Russia 12A, Karbyshev St., Kazan, Republic of Tatarstan 420101

Objective: to evaluate the effect of intravenous mexidol on the efficiency of intravenous thrombolytic therapy (TLT) during the therapeutic window. Patients and methods. The retrospective study enrolled 123 patients with ischemic stroke (IS) who had undergone intravenous TLT in the vascular centers of the Republic of Tatarstan. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the time course of changes in their neurological status. According to the baseline severity of a neurological deficit, all the patients were divided into three subgroups: 1) mild IS (<8 NIHSS scores at admission); 2) moderate IS (>8 scores); and 3) severe IS (<16 scores). All the patients underwent X-ray computed tomography at admission, at 24 hours after TLT, and in case of worsening of their health status. Results. The prehospital use of mexidol followed by TLT in patients with IS had a positive effect on the regression of neurological deficit regardless of the severity of the disease. There were significant differences in the degree of regression of neurological deficit according to NIHSS at 24 hours and 10 days after hospital admission in patients with severe IS, who received intravenous mexidol at the prehospital stage and who did not take this drug before TLT. The pre-TLT use of mexidol contributed to higher regression of neurological deficit. There was a lower frequency of hemorrhagic transformations in the patients who used mexidol at the prehospital stage versus those who did not. Conclusion. The findings demonstrate the positive effect of mexidol on the efficiency and safety of TLT in patients with IS.

Keywords: ethylmethylhydroxypyridine succinate; intravenous thrombolytic therapy; ischemic stroke; neuroprotective therapy.