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Pioglitazone for Secondary Stroke Prevention Clinical Sciences
Conclusions—Pioglitazone reduces recurrent stroke and major vascular events in ischemic stroke patients with insulin resistance, prediabetes, and diabetes mellitus.
Source: Stroke - January 22, 2017 Category: Neurology Authors: Meng Lee, Jeffrey L. Saver, Hung-Wei Liao, Chun-Hsien Lin, Bruce Ovbiagele Tags: Cardiovascular Disease, Diabetes, Type 2, Secondary Prevention, Meta Analysis, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Smoking cessation and outcome after ischemic stroke or TIA
Conclusion: Cessation of cigarette smoking after an ischemic stroke or TIA was associated with significant health benefits over 4.8 years in the IRIS trial cohort.
Source: Neurology - October 16, 2017 Category: Neurology Authors: Epstein, K. A., Viscoli, C. M., Spence, J. D., Young, L. H., Inzucchi, S. E., Gorman, M., Gerstenhaber, B., Guarino, P. D., Dixit, A., Furie, K. L., Kernan, W. N., For the IRIS Trial Investigators Tags: Stroke prevention, Prognosis, All Cerebrovascular disease/Stroke, Infarction ARTICLE Source Type: research

Hyperglycemia and PPAR{gamma} Antagonistically Influence Macrophage Polarization and Infarct Healing After Ischemic Stroke Basic Sciences
Conclusions— Hyperglycemia and macrophage-specific PPAR activation exert opposing effects on MO/MP polarization in ischemic stroke lesions and, thereby, critically determine the risk of hemorrhagic infarct transformation.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Gliem, M., Klotz, L., van Rooijen, N., Hartung, H.-P., Jander, S. Tags: Animal models of human disease, Coumarins, Other diabetes, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Anticoagulants Basic Sciences Source Type: research

Sodium-Glucose Cotransporter-2 Inhibitors and Protection Against stroke in Patients with type 2 Diabetes and Impaired Renal Function: A Systematic Review and Meta-Analysis
It is well established that diabetes mellitus type 2 (T2DM) is associated with increased risk of cardiovascular disease, including ischemic stroke. Among past antidiabetic agents, only pioglitazone and glucagon-like peptide 1 receptor agonists (GLP-1RA) have been shown to decrease the risk of stroke.1-5 Similarly, sodium-glucose cotransporter-2 inhibitors (SGLT2i) were expected to reduce the risk of stroke, considering their blood pressure lowering and neuroprotective effects demonstrated by experimental studies.
Source: Journal of Stroke and Cerebrovascular Diseases - March 10, 2021 Category: Neurology Authors: Fotios Barkas, Sebastian Filippas Ntekouan, Evangelos Liberopoulos, Theodosios Filippatos, Haralampos Milionis Source Type: research

Letter by Castilla-Guerra et al Regarding Article, “Pioglitazone for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis” Letter to the Editor
Source: Stroke - April 24, 2017 Category: Neurology Authors: Luis Castilla–Guerra, Maria del Carmen Fernandez–Moreno, Jose Antonio Perez de Leon Tags: Diabetes, Type 2, Risk Factors, Secondary Prevention, Cerebrovascular Disease/Stroke, Vascular Disease Letters to the Editor Source Type: research

Response by Lee and Ovbiagele to Letter Regarding Article, “Pioglitazone for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis” Letter to the Editor
Source: Stroke - April 24, 2017 Category: Neurology Authors: Meng Lee, Bruce Ovbiagele Tags: Meta Analysis, Ischemic Stroke Letters to the Editor Source Type: research

Letter by Iguchi and Nango Regarding Article, “Pioglitazone for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis” Letter to the Editor
Source: Stroke - June 26, 2017 Category: Neurology Authors: Masahiro Iguchi, Eishu Nango Tags: Diabetes, Type 2, Secondary Prevention, Cerebrovascular Disease/Stroke Letters to the Editor Source Type: research

Response by Lee et al to Letter Regarding Article, “Pioglitazone for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis” Letter to the Editor
Source: Stroke - June 26, 2017 Category: Neurology Authors: Meng Lee, Jeffrey L. Saver, Bruce Ovbiagele Tags: Meta Analysis, Ischemic Stroke Letters to the Editor Source Type: research

Medical Management for Secondary Stroke Prevention
This article reviews the evidence base and recommendations for medical management for secondary stroke prevention. RECENT FINDINGS Recent developments for secondary stroke prevention include evidence to support the use of short-term dual antiplatelet therapy after minor stroke and transient ischemic attack, direct oral anticoagulants for nonvalvular atrial fibrillation, reversal agents for direct oral anticoagulant–associated hemorrhage, and aspirin rather than presumptive anticoagulation with a direct oral anticoagulant for embolic stroke of undetermined source. SUMMARY Most strokes are preventable. The mainstays ...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Stroke Prevention: Little-Known and Neglected Aspects
Combining available therapies has the potential to reduce the risk of stroke by 80% or more. A comprehensive review of all aspects of stroke prevention would be very lengthy; in this narrative review, we focus on some aspects of stroke prevention that are little-known and/or neglected. These include the following: (1) implementation of a Mediterranean diet; (2) B vitamins to lower homocysteine; (3) coordinated approaches to smoking cessation; (4) intensive lipid-lowering therapy; (5) lipid lowering in the elderly; (6) physiologically individualized therapy for hypertension based on renin/aldosterone phenotyping; (7) avoidi...
Source: Cerebrovascular Diseases - May 27, 2021 Category: Neurology Source Type: research

Diabetes drug may prevent recurring strokes
Pioglitazone, a drug used for type 2 diabetes, may prevent recurrent stroke and heart attacks in people with insulin resistance but without diabetes. The results of the Insulin Resistance Intervention after Stroke (IRIS) trial, presented at the International Stroke Conference 2016 in Los Angeles and published in the New England Journal of Medicine, suggest a potential new method to prevent stroke and heart attack in high-risk patients who have already had one stroke or transient ischemic attack.
Source: NINDS Press Releases and News: National Institute of Neurological Disorders and Stroke - February 17, 2016 Category: Neurology Source Type: news

IRIS: Diabetes Drug Reduces Recurrent Stroke, MIIRIS: Diabetes Drug Reduces Recurrent Stroke, MI
A randomized trial shows that in patients with insulin resistance but no diabetes and a history of recent stroke or TIA, pioglitazone reduced recurrent stroke and myocardial infarction vs placebo. Medscape Medical News
Source: Medscape Neurology and Neurosurgery Headlines - February 17, 2016 Category: Neurology Tags: Neurology & Neurosurgery News Source Type: news

Which Patients With Ischemic Stroke and Insulin Resistance May Benefit From Pioglitazone?
The Insulin Resistance Intervention After Stroke (IRIS) trial has reported that treating insulin resistance with the peroxisome proliferator –activated receptor γ agonist pioglitazone hydrochloride reduced recurrent stroke or myocardial infarction (MI) by about one-fourth compared with placebo (pioglitazone, 9.0% vs placebo, 11.8%; hazard ratio [HR], 0.76; 95% CI, 0.62-0.93) in 3876 patients with recent (<6 months) ischemic stroke or transient ischemic attack and insulin resistance but without diabetes, heart failure, or bladder cancer. Pioglitazone was also associated with less incident diabetes vs placebo (3.8% vs ...
Source: JAMA Neurology - September 18, 2017 Category: Neurology Source Type: research

Targeting Pioglitazone Therapy After Stroke or Transient Ischemic Attack
This secondary analysis of the Insulin Resistance Intervention After Stroke trial estimates the relative and absolute effectiveness of pioglitazone after ischemic stroke or transient ischemic attack in subgroups of patients defined by pretreatment risk for stroke or myocardial infarction.
Source: JAMA Neurology - September 18, 2017 Category: Neurology Source Type: research

Treatment with the PPAR γ Agonist Pioglitazone in the Early Post-ischemia Phase Inhibits Pro-inflammatory Responses and Promotes Neurogenesis Via the Activation of Innate- and Bone Marrow-Derived Stem Cells in Rats
AbstractNeurogenesis is essential for a good post-stroke outcome. Exogenous stem cells are currently being tested to promote neurogenesis after stroke. Elsewhere, we demonstrated that treatment with the PPAR γ agonist pioglitazone (PGZ) before cerebral ischemia induction reduced brain damage and activated survival-related genes in ovariectomized (OVX) rats. Here, we tested our hypothesis that post-ischemia treatment with PGZ inhibits brain damage and contributes to neurogenesis via activated stem cells . Bone marrow (BM) cells of 7-week-old Wistar female rats were replaced with BM cells from green fluorescent protein-tran...
Source: Translational Stroke Research - November 6, 2017 Category: Neurology Source Type: research

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