Investigation of Effect of Edaravone on Ischemic Stroke

Abstract

A novel free radical scavenger, edaravone, has been demonstrated to exert a neuroprotective effect and improve outcomes in acute ischemic stroke, but there have been few clinical studies. Therefore, we investigated retrospectively whether the administration of edaravone at the acute stage of ischemic stroke can improve outcomes of the disease at the time of discharge. Between January 1998 and December 2011, 625 consecutive patients (331 males and 294 females: mean age 77.0 years, range 36-101 years) with acute ischemic stroke who were admitted to our institution within 48 hours after stroke onset were enrolled. Subtypes of strokes were lacunar infarction (LI) in 188 (30.0%), atherothrombotic infarction (ATCI) in 268 (42.0%), and cardioembolic infarction (CEI) in 169 (27.0%). Of the 625 patients, 237 (37.0%) received both edaravone and conventional treatment, while the other 388 (62.0%) patients underwent conventional treatment only. As a conventional treatment, 422 (67.0%) of 625 patients were treated with ozagrel sodium, and 37 patients received argatroban. The overall outcomes at discharge were favorable (modified Rankin Scale score 0-2) in 296 (47.4%) and death occurred (mRS score 6) in 86 (13.8%). In a univariate analysis, the administration of edaravone did not have a significant effect on total death from all types of cerebral infarction. However, treatment with edaravone showed a favorable tendency (p=0.099) compared to conventional treatment after adjustments for age and gender. Further investigation is required before a definite conclusion can be made.