检查钙通道阻滞剂在卒中患者死亡率和发病率中的治疗潜力和副作用：临床前和临床研究的系统回顾

IF 2 Q3 NEUROSCIENCES

IBRO Neuroscience Reports Pub Date : 2025-01-08 DOI:10.1016/j.ibneur.2025.01.002

Sevak Hatamian , Asad Abdi , Fatemeh Sadat Seyedi Asl , Armin Tafazolimoghadam , Arian Tavasol , Seyed Ali Mousavi Nejad , Reza Madadi , Zohre Tajabadi , Mina Dehghani , Najmeh Ahmadpoor , Mobina Fathi , Mohammadreza Hajiesmaeili , Navid Nooraei

{"title":"检查钙通道阻滞剂在卒中患者死亡率和发病率中的治疗潜力和副作用：临床前和临床研究的系统回顾","authors":"Sevak Hatamian , Asad Abdi , Fatemeh Sadat Seyedi Asl , Armin Tafazolimoghadam , Arian Tavasol , Seyed Ali Mousavi Nejad , Reza Madadi , Zohre Tajabadi , Mina Dehghani , Najmeh Ahmadpoor , Mobina Fathi , Mohammadreza Hajiesmaeili , Navid Nooraei","doi":"10.1016/j.ibneur.2025.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Blood pressure control is one of the basic steps in preventing stroke and cerebrovascular events. Calcium channel blockers are the first-line drugs in hypertension control. On the other hand, the stroke recovery phase depends on activating calcium channels and N-methyl-D-aspartate (NMDA) receptors. Considering these issues, one of the interdisciplinary challenges of neurology and cardiology is the use of these drugs in hypertensive patients with cerebrovascular accident (CVA) risk and their uses after these events.</div></div><div><h3>Objectives</h3><div>This study's primary goal is to evaluate the effects of calcium channel blockers on reducing the risk, mortality, morbidity, and long-term outcomes of cerebrovascular events.</div></div><div><h3>Material and Methods</h3><div>We conducted this systematic literature review by searching PubMed, Scopus, and Google Scholar databases. Our inclusion criteria were randomized clinical trials, cohort studies, case-cross-over studies, case reports, and in-vitro and animal studies in which they evaluated the effects of calcium channel blockers on the CVA risk and mortality, morbidity, and long-term outcomes of stroke. Our exclusion criteria were review studies with no adequate data and non-English articles. Articles that met our criteria were included in the initial search. After the title and abstract screening, 56 human and animal studies were selected to be discussed in this article.</div></div><div><h3>Results</h3><div>Among 56 selected studies, 33 were human studies, 23 were animal experiments, and one study was carried out both on animals and humans. A total of 1,860,234 patients were enrolled in 24 human studies. A total of 717,131 patients in 22 studies received CCBs. Two studies did not report the number of patients who underwent treatment with CCBs. Among 24 studies, 11 reported favorable outcomes following CCB administration, and two studies reported neuroprotective effects for CCBs without any adverse outcome in stroke patients. Five studies demonstrated that CCBs were associated with adverse outcomes. One study showed favorable and unfavorable outcomes compared to other antihypertensive agents. Stroke was reported in two studies following CCB overdose. Three studies have reported that CCBs had no significant effect on stroke risk, mortality, or long-term outcomes. In animal studies, a total of 813 animals were enrolled in 19 studies. Two studies were in vitro using mammalian cells and enzymes, and one study was ex-vivo. Among 24 studies, 18 (75 %) reported beneficial outcomes following treatment with CCBs, three (12.5 %) revealed both favorable and unfavorable results, two (8.3 %) demonstrated adverse outcomes, and one (4.2 %) showed no effect.</div></div><div><h3>Conclusion</h3><div>Based on the evidence from human and animal studies, authors conclude that CCBs are associated with a lower risk of stroke, lower mortality risk, and improved long-term neurological and other clinical outcomes.</div></div>","PeriodicalId":13195,"journal":{"name":"IBRO Neuroscience Reports","volume":"18 ","pages":"Pages 222-243"},"PeriodicalIF":2.0000,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Examining the therapeutic potential and side effects of calcium channel blockers in mortality and morbidity of patients with stroke: A systematic review of pre-clinical and clinical studies\",\"authors\":\"Sevak Hatamian , Asad Abdi , Fatemeh Sadat Seyedi Asl , Armin Tafazolimoghadam , Arian Tavasol , Seyed Ali Mousavi Nejad , Reza Madadi , Zohre Tajabadi , Mina Dehghani , Najmeh Ahmadpoor , Mobina Fathi , Mohammadreza Hajiesmaeili , Navid Nooraei\",\"doi\":\"10.1016/j.ibneur.2025.01.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Blood pressure control is one of the basic steps in preventing stroke and cerebrovascular events. Calcium channel blockers are the first-line drugs in hypertension control. On the other hand, the stroke recovery phase depends on activating calcium channels and N-methyl-D-aspartate (NMDA) receptors. Considering these issues, one of the interdisciplinary challenges of neurology and cardiology is the use of these drugs in hypertensive patients with cerebrovascular accident (CVA) risk and their uses after these events.</div></div><div><h3>Objectives</h3><div>This study's primary goal is to evaluate the effects of calcium channel blockers on reducing the risk, mortality, morbidity, and long-term outcomes of cerebrovascular events.</div></div><div><h3>Material and Methods</h3><div>We conducted this systematic literature review by searching PubMed, Scopus, and Google Scholar databases. Our inclusion criteria were randomized clinical trials, cohort studies, case-cross-over studies, case reports, and in-vitro and animal studies in which they evaluated the effects of calcium channel blockers on the CVA risk and mortality, morbidity, and long-term outcomes of stroke. Our exclusion criteria were review studies with no adequate data and non-English articles. Articles that met our criteria were included in the initial search. After the title and abstract screening, 56 human and animal studies were selected to be discussed in this article.</div></div><div><h3>Results</h3><div>Among 56 selected studies, 33 were human studies, 23 were animal experiments, and one study was carried out both on animals and humans. A total of 1,860,234 patients were enrolled in 24 human studies. A total of 717,131 patients in 22 studies received CCBs. Two studies did not report the number of patients who underwent treatment with CCBs. Among 24 studies, 11 reported favorable outcomes following CCB administration, and two studies reported neuroprotective effects for CCBs without any adverse outcome in stroke patients. Five studies demonstrated that CCBs were associated with adverse outcomes. One study showed favorable and unfavorable outcomes compared to other antihypertensive agents. Stroke was reported in two studies following CCB overdose. Three studies have reported that CCBs had no significant effect on stroke risk, mortality, or long-term outcomes. In animal studies, a total of 813 animals were enrolled in 19 studies. Two studies were in vitro using mammalian cells and enzymes, and one study was ex-vivo. Among 24 studies, 18 (75 %) reported beneficial outcomes following treatment with CCBs, three (12.5 %) revealed both favorable and unfavorable results, two (8.3 %) demonstrated adverse outcomes, and one (4.2 %) showed no effect.</div></div><div><h3>Conclusion</h3><div>Based on the evidence from human and animal studies, authors conclude that CCBs are associated with a lower risk of stroke, lower mortality risk, and improved long-term neurological and other clinical outcomes.</div></div>\",\"PeriodicalId\":13195,\"journal\":{\"name\":\"IBRO Neuroscience Reports\",\"volume\":\"18 \",\"pages\":\"Pages 222-243\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-01-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IBRO Neuroscience Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S266724212500003X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IBRO Neuroscience Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S266724212500003X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

摘要

血压控制是预防脑卒中和脑血管事件的基本步骤之一。钙通道阻滞剂是控制高血压的一线药物。另一方面，脑卒中恢复阶段依赖于激活钙通道和n -甲基- d -天冬氨酸（NMDA）受体。考虑到这些问题，神经病学和心脏病学的跨学科挑战之一是这些药物在脑血管意外（CVA）风险高血压患者中的使用及其事件后的应用。本研究的主要目的是评估钙通道阻滞剂在降低脑血管事件的风险、死亡率、发病率和长期预后方面的作用。材料和方法我们通过检索PubMed、Scopus和b谷歌Scholar数据库进行了系统的文献综述。我们的纳入标准是随机临床试验、队列研究、病例交叉研究、病例报告以及体外和动物研究，在这些研究中，我们评估了钙通道阻滞剂对CVA风险、死亡率、发病率和卒中长期结局的影响。我们的排除标准是没有足够数据和非英文文章的回顾性研究。符合我们标准的文章被包含在最初的搜索中。经过题目和摘要筛选，本文选择了56项人类和动物研究进行讨论。结果56项入选研究中，33项为人体实验，23项为动物实验，1项研究为动物和人类同时进行。24项人体研究共纳入了1,860,234名患者。22项研究共有717,131名患者接受了CCBs。两项研究没有报告接受CCBs治疗的患者数量。在24项研究中，11项研究报告了CCB给药后的良好结果，2项研究报告了CCB对脑卒中患者的神经保护作用，无任何不良结果。五项研究表明，CCBs与不良后果有关。一项研究显示了与其他抗高血压药物相比的有利和不利结果。两项研究报告了CCB过量后的卒中。三项研究报告CCBs对卒中风险、死亡率或长期预后没有显著影响。在动物研究中，19项研究共纳入813只动物。两项研究是在体外使用哺乳动物细胞和酶进行的，一项研究是在体外进行的。在24项研究中，18项（75 %）报告了CCBs治疗后的有益结果，3项（12.5 %）显示了有利和不利的结果，2项（8.3 %）显示了不良结果，1项（4.2 %）显示没有效果。基于人类和动物研究的证据，作者得出结论，CCBs与较低的中风风险、较低的死亡风险以及改善的长期神经学和其他临床结果相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Examining the therapeutic potential and side effects of calcium channel blockers in mortality and morbidity of patients with stroke: A systematic review of pre-clinical and clinical studies

Background

Blood pressure control is one of the basic steps in preventing stroke and cerebrovascular events. Calcium channel blockers are the first-line drugs in hypertension control. On the other hand, the stroke recovery phase depends on activating calcium channels and N-methyl-D-aspartate (NMDA) receptors. Considering these issues, one of the interdisciplinary challenges of neurology and cardiology is the use of these drugs in hypertensive patients with cerebrovascular accident (CVA) risk and their uses after these events.

Objectives

This study's primary goal is to evaluate the effects of calcium channel blockers on reducing the risk, mortality, morbidity, and long-term outcomes of cerebrovascular events.

Material and Methods

We conducted this systematic literature review by searching PubMed, Scopus, and Google Scholar databases. Our inclusion criteria were randomized clinical trials, cohort studies, case-cross-over studies, case reports, and in-vitro and animal studies in which they evaluated the effects of calcium channel blockers on the CVA risk and mortality, morbidity, and long-term outcomes of stroke. Our exclusion criteria were review studies with no adequate data and non-English articles. Articles that met our criteria were included in the initial search. After the title and abstract screening, 56 human and animal studies were selected to be discussed in this article.

Results

Among 56 selected studies, 33 were human studies, 23 were animal experiments, and one study was carried out both on animals and humans. A total of 1,860,234 patients were enrolled in 24 human studies. A total of 717,131 patients in 22 studies received CCBs. Two studies did not report the number of patients who underwent treatment with CCBs. Among 24 studies, 11 reported favorable outcomes following CCB administration, and two studies reported neuroprotective effects for CCBs without any adverse outcome in stroke patients. Five studies demonstrated that CCBs were associated with adverse outcomes. One study showed favorable and unfavorable outcomes compared to other antihypertensive agents. Stroke was reported in two studies following CCB overdose. Three studies have reported that CCBs had no significant effect on stroke risk, mortality, or long-term outcomes. In animal studies, a total of 813 animals were enrolled in 19 studies. Two studies were in vitro using mammalian cells and enzymes, and one study was ex-vivo. Among 24 studies, 18 (75 %) reported beneficial outcomes following treatment with CCBs, three (12.5 %) revealed both favorable and unfavorable results, two (8.3 %) demonstrated adverse outcomes, and one (4.2 %) showed no effect.

Conclusion

Based on the evidence from human and animal studies, authors conclude that CCBs are associated with a lower risk of stroke, lower mortality risk, and improved long-term neurological and other clinical outcomes.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊