The Role of Sartans in the Treatment of Stroke and Subarachnoid Hemorrhage: A Narrative Review of Preclinical and Clinical Studies.

Wanderer, Stefan; Grüter, Basil E.; Strange, Fabio; Sivanrupan, Sivani; Di Santo, Stefano; Widmer, Hans Rudolf; Fandino, Javier; Marbacher, Serge; Andereggen, Lukas (2020). The Role of Sartans in the Treatment of Stroke and Subarachnoid Hemorrhage: A Narrative Review of Preclinical and Clinical Studies. Brain Sciences, 10(3) MDPI 10.3390/brainsci10030153

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Background: Delayed cerebral vasospasm (DCVS) due to aneurysmal subarachnoid hemorrhage (aSAH) and its sequela, delayed cerebral ischemia (DCI), are associated with poor functional outcome. Endothelin-1 (ET-1) is known to play a major role in mediating cerebral vasoconstriction. Angiotensin-II-type-1-receptor antagonists such as Sartans may have a beneficial effect after aSAH by reducing DCVS due to crosstalk with the endothelin system. In this review, we discuss the role of Sartans in the treatment of stroke and their potential impact in aSAH. Methods: We conducted a literature research of the MEDLINE PubMed database in accordance with PRISMA criteria on articles published between 1980 to 2019 reviewing: "Sartans AND ischemic stroke". Of 227 studies, 64 preclinical and 19 clinical trials fulfilled the eligibility criteria. Results: There was a positive effect of Sartans on ischemic stroke in both preclinical and clinical settings (attenuating ischemic brain damage, reducing cerebral inflammation and infarct size, increasing cerebral blood flow). In addition, Sartans reduced DCVS after aSAH in animal models by diminishing the effect of ET-1 mediated vasoconstriction (including cerebral inflammation and cerebral epileptogenic activity reduction, cerebral blood flow autoregulation restoration as well as pressure-dependent cerebral vasoconstriction). Conclusion: Thus, Sartans might play a key role in the treatment of patients with aSAH.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Di Santo, Stefano and Widmer, Hans Rudolf

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2076-3425

Publisher:

MDPI

Language:

English

Submitter:

Nicole Söll

Date Deposited:

07 Jul 2020 15:12

Last Modified:

11 Aug 2020 03:18

Publisher DOI:

10.3390/brainsci10030153

PubMed ID:

32156050

Uncontrolled Keywords:

Sartans aneurysmal subarachnoid hemorrhage delayed cerebral vasospasm ischemic stroke therapeutic interventions

BORIS DOI:

10.7892/boris.145033

URI:

https://boris.unibe.ch/id/eprint/145033

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