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Review
Anti-inflammatory approaches to ischaemic stroke prevention
  1. Peter J Kelly1,
  2. Sean Murphy2,3,
  3. Sarah Coveney1,
  4. Francisco Purroy4,
  5. Robin Lemmens5,6,7,
  6. Georgios Tsivgoulis8,9,
  7. Chris Price10
  1. 1Health Research Board Irish Stroke Clinical Trials Network and Mater University Hospital/University College Dublin, Dublin, Ireland
  2. 2Royal College of Surgeons Ireland, Dublin, Ireland
  3. 3Mater University Hospital/University College Dublin, Dublin, Ireland
  4. 4Stroke Unit, Department of Neurology, Hospitalt Universitari Arnau de Vilanova de Lleida and Universitat de Lleida, Biomedical Research Institute of Lleida, Universitat de Lleida, Spain, Dublin, Ireland
  5. 5Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven - University of Leuven, Leuven, Belgium
  6. 6Department of Neurology, University Hospitals Leuven, Leuven, Belgium
  7. 7VIB Center for Brain and Disease Research, Laboratory of Neurobiology, Leuven, Belgium
  8. 8Second Department of Neurology, “Attikon” Hospital, University of Athens, School of Medicine, Athens, Greece
  9. 9Department of Neurology, Universityof Tennessee Health Science Center, Memphis, TN
  10. 10Institute of Neuroscience, Newcastle University, Newcastle, UK
  1. Correspondence to Professor Peter J Kelly, Health Research Board Irish Stroke Clinical Trials Network and Mater University Hospital/University College Dublin, Dublin, Ireland; pjkelly{at}mater.ie

Abstract

Stroke is a major cause of neurological morbidity and mortality. Atherosclerosis is a major contributor to first and recurrent stroke. A growing evidence base indicates that inflammation is a key process in the pathogenesis of atherosclerosis, leading to thromboembolic events. In this review, we summarise the evidence linking inflammation to stroke risk and discuss clinical trials addressing the ’inflammation hypothesis' in coronary disease and stroke.

Trial registration number CONVINCE trial ClinicalTrials.gov number;NCT 02898610;Pre-results.

  • stroke

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Footnotes

  • Contributors All authors fulfil ICMJE guidelines for authorship as follows: Professor Kelly contributed to the conception of the article, the design of the systematic search of trials of anti-inflammatory medication for stroke prevention and interpretation of search data. He wrote the first draft and critically revised the manuscript for important intellectual content. He gave final approval of the version published. He agrees to be accountable for all aspects of the work in accordance with ICMJE guidelines. Professor Murphy, Professor Price, ProfessorTsivgoulis, Professor Lemmens and Professor Purroy contributed to the conception of the article, contributed to revised drafts of the manuscript and critically revised the manuscript for important intellectual content. They gave final approval of the version published. They agree to be accountable for all aspects of the work in accordance with ICMJE guidelines. Dr Coveney contributed to the conception of the article, contributed to revised drafts of the manuscript and critically revised the manuscript for important intellectual content. She conducted the search of anti-inflammatory therapies for secondary stroke prevention, summarised and interpreted the findings. She gave final approval of the version published. She agrees to be accountable for all aspects of the work in accordance with ICMJE guidelines.

  • Competing interests PJK is chief investigator of the CONVINCE (COlchicine for preventioN of Vascular Inflammation in Non-Cardio-Embolic stroke) trial funded by the Health Research Board of Ireland. SM, FP, RL, GT and CP are national lead investigators for CONVINCE in their respective countries and serve on the trial steering committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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