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May 10, 2000

Ancrod—Is Snake Venom an Antidote for Stroke?

Author Affiliations

Author Affiliations: Cleveland Clinic Foundation, Cleveland, Ohio.

JAMA. 2000;283(18):2440-2442. doi:10.1001/jama.283.18.2440

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 trial.5,6