Neuroprotective Effects of Erythropoietin in Acute Ischemic Stroke

Abstract

Background: Ischemic brain strokes consisttwo‑thirdsof strokesand their complications bear a lot of disability for patient and society. In this study, we seek for effect of Erythropoietin on ischemic brain stroke’s outcomes according to National Institutes of Health Stroke Scale (NIHSS) changes.

Methods: This study is a RCT (randomized clinical trial). All patients with focal neurologic deficit with primary suspicion of brain stroke undergone neuroimaging evaluations.After confirmation of new ischemic brain stroke, the patients with inclusion criteria’srandomized into two groups of cases and controls.

NIHSS was defined for each patient and all patients received a routine treatment protocol. Erythropoietin 16,000 IU as a bolus intravenous dose was given to case patients as soon as neuroimaging study confirmed new ischemic stroke and continued as 8000 IU each 12 h up to total dose of 56,000 IU during 3 days. Patients re‑evaluated at days 14 and 28 and NIHSS was assessed by another neurologist blinded to patient’s group. Finally, NIHSS changes of both groups compared with each other’s.

Results: Evaluations revealed that in days14 and 28 during follow‑up, Erythropoietin was effective in NIHSS (P= 0.0001). This effect was of value in level of consciousness Commands (P= 0.024), facial palsy (P= 0.003), motor arm (P= 0.0001), motor leg (P= 0.0001), sensory (P= 0.009), and best language (P= 0.023).

Conclusions: Administration of high‑dose erythropoietin in first 24 h can be effective on reduction of ischemic stroke complication. A larger scale clinical trial is warranted.

Keywords: Erythropoietin, national institutes of health stroke scale, neuroprotection, stroke