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01-04-2014 | Original Article

Glyburide is Associated with Attenuated Vasogenic Edema in Stroke Patients

Authors: W. Taylor Kimberly, Thomas W. K. Battey, Ly Pham, Ona Wu, Albert J. Yoo, Karen L. Furie, Aneesh B. Singhal, Jordan J. Elm, Barney J. Stern, Kevin N. Sheth

Published in: Neurocritical Care | Issue 2/2014

Abstract

Background

Brain edema is a serious complication of ischemic stroke that can lead to secondary neurological deterioration and death. Glyburide is reported to prevent brain swelling in preclinical rodent models of ischemic stroke through inhibition of a non-selective channel composed of sulfonylurea receptor 1 and transient receptor potential cation channel subfamily M member 4. However, the relevance of this pathway to the development of cerebral edema in stroke patients is not known.

Methods

Using a case–control design, we retrospectively assessed neuroimaging and blood markers of cytotoxic and vasogenic edema in subjects who were enrolled in the glyburide advantage in malignant edema and stroke-pilot (GAMES-Pilot) trial. We compared serial brain magnetic resonance images (MRIs) to a cohort with similar large volume infarctions. We also compared matrix metalloproteinase-9 (MMP-9) plasma level in large hemispheric stroke.

Results

We report that IV glyburide was associated with T2 fluid-attenuated inversion recovery signal intensity ratio on brain MRI, diminished the lesional water diffusivity between days 1 and 2 (pseudo-normalization), and reduced blood MMP-9 level.

Conclusions

Several surrogate markers of vasogenic edema appear to be reduced in the setting of IV glyburide treatment in human stroke. Verification of these potential imaging and blood biomarkers is warranted in the context of a randomized, placebo-controlled trial.

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Title: Glyburide is Associated with Attenuated Vasogenic Edema in Stroke Patients
Authors: W. Taylor Kimberly
Thomas W. K. Battey
Ly Pham
Ona Wu
Albert J. Yoo
Karen L. Furie
Aneesh B. Singhal
Jordan J. Elm
Barney J. Stern
Kevin N. Sheth
Publication date: 01-04-2014
Publisher: Springer US
Published in: Neurocritical Care / Issue 2/2014
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-013-9917-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Glyburide is Associated with Attenuated Vasogenic Edema in Stroke Patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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