The quest for the “Holy Grail” of ischemic stroke cytoprotection
Statins may not be the answer
Citation Manager Formats
Make Comment
See Comments

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Coronary artery bypass grafting (CABG) has been performed for over 40 years. Operative techniques have evolved, and CABG can now be done either with or without cardiopulmonary bypass, the latter being associated with lower 1-year rates of death, myocardial infarction, and stroke in at least some series.1 Despite surgical refinements, post-CABG stroke, encephalopathy, and cognitive decline remain important clinical problems.2
Prospective studies demonstrate post-CABG stroke rates up to 5.2% with encephalopathy occurring in 14%.2 The pathophysiologic bases of these neurologic complications may in part be related to microemboli, hypoperfusion, and postoperative atrial fibrillation. Independent risk factors for neurologic perioperative events are similar to those for systemic vascular disease (e.g., hypertension, diabetes, peripheral vascular disease, prior stroke, and age).2 Although predictive models can be helpful in identifying CABG patients at untoward neurologic risk, drugs to protect the brain would have the potential to decrease the consequences of ischemic injury.
Achieving the goal of identifying a clinically effective cytoprotective drug that could positively and meaningfully affect patient outcomes when given after ischemic stroke has been elusive. Of the numerous compounds having such properties in laboratory experiments, none has proven beneficial in clinical trials.3 There are …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Disputes & Debates: Rapid online correspondence
NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.
- Stay timely. Submit only on articles published within the last 8 weeks.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- 200 words maximum.
- 5 references maximum. Reference 1 must be the article on which you are commenting.
- 5 authors maximum. Exception: replies can include all original authors of the article.
- Submitted comments are subject to editing and editor review prior to posting.