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A Prospective, Multi-Center, Randomized Study of the Efficacy of Eicosapentaenoic Acid for Cerebral Vasospasm: the EVAS Study.
MedLine Citation:
PMID:  23032083     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The sphingosylphosphorylcholine (SPC)-Rho-kinase pathway plays an important role in Ca(2+)-sensitization of vascular smooth muscle contraction. Eicosapentaenoic acid (EPA) inhibits SPC-Rho-kinase-activated Ca(2+)-sensitization in vitro and in subarachnoid hemorrhage (SAH) models in vivo, and has also been shown to inhibit the occurrence of cerebral vasospasm after SAH onset in a prospective, non-randomized study. The current prospective, multicenter, randomized study was performed to confirm the preventive effects of EPA on cerebral vasospasm in patients with SAH. METHODS: The trial population comprised 162 patients who underwent surgical clipping within 72 h of SAH onset. Of these patients, 81 received 2700 mg/day EPA from the day after surgery until day 30 (EPA group) and 81 did not receive EPA (control group). The primary endpoint was the occurrence of symptomatic vasospasm (SV) or cerebral infarction caused by cerebral vasospasm (CIV). RESULTS: The occurrences of SV (15% vs. 30%, P = 0.022) and CIV (7% vs. 21%; P = 0.012) were lower in the EPA group. Multivariate analysis revealed an adjusted odds ratio of 0.39 (95% CI, 0.17-0.89; P = 0.028) for SV inhibition by EPA and 0.27 (95% CI, 0.09-0.72; P = 0.012) for CIV inhibition. CONCLUSION: These results indicate that oral EPA reduces the frequency of SV and CIV after the onset of aneurysmal SAH.
Authors:
Hiroshi Yoneda; Satoshi Shirao; Jyoji Nakagawara; Kuniaki Ogasawara; Teiji Tominaga; Michiyasu Suzuki
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-29
Journal Detail:
Title:  World neurosurgery     Volume:  -     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-10-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
Affiliation:
Department of Neurosurgery and Clinical Neuroscience, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan; Department of Neurosurgery, Ootemachi Hospital, Kitakyushu, Fukuoka, Japan. Electronic address: h-yoneda@yamaguchi-u.ac.jp.
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