Author Affiliations: Cleveland Clinic Foundation, Cleveland, Ohio.
Elevated serum fibrinogen levels have been associated with poor outcome
in patients with acute ischemic stroke.1 Although
the causality and specific mechanisms of the relationship between increased
fibrinogen and stroke remain speculative, it has been proposed that lower
fibrinogen levels after stroke may accelerate spontaneous fibrinolysis, inhibit
thrombus propagation, promote the release of endogenous tissue-type plasminogen
activator (tPA), or improve local cerebral blood flow through diminished viscosity.2 Ancrod is a protease derived from Malaysian pit viper
venom that produces rapid decreases in serum fibrinogen by accelerating cleavage
of the fibrinogen A-α chain.3 Ancrod
has been shown to be effective in limiting infarction volume in animal models
of acute stroke4 and in a randomized clinical
Mayberg MR, Furlan A. Ancrod—Is Snake Venom an Antidote for Stroke? JAMA. 2000;283(18):2440–2442. doi:10.1001/jama.283.18.2440
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