Ninety-two patients who had suffered a recent moderate to severe ischemic stroke
Cuban policosanol (20 mg/day) plus aspirin (125 mg/day) compared to placebo plus aspirin 125 mg/day during 24 weeks
Combination therapy significantly improved the neurological score and reduced platelet aggregation with more efficacy than aspirin monotherapy. Unlike aspirin the combination produced antioxidant effect. Treatments were well tolerated
Sixty patients that recently suffered an ischemic stroke 30 days after stroke onset
Cuban policosanol (20 mg/day) plus aspirin (125 mg/day) and atorvastatin (20 mg/day) plus aspirin (125 mg/day) for 12 weeks
Both combinations therapies improved similarly neurological recovery and prevented recurrent cerebrovascular events. Both combinations reduced cholesterol, with atorvastatin being more effective, unlike which policosanol increased HDL-C
Avan A, Hachinski V. Stroke and dementia, leading causes of neurological disability and death, potential for prevention.Alzheimers Dement. 2021;17:1072–6. [DOI] [PubMed]
Madden JA. Role of the vascular endothelium and plaque in acute ischemic stroke.Neurology. 2012;79:S58–62. [DOI] [PubMed]
Li J, Sasaki H, Fujiwara H, Kato H, Kaneko K, Yamazaki Y, et al. Synaptic plasticity in hippocampal CA1 neurons and learning behavior in transient ischemia-loaded gerbils.Biomed Res. 2013;34:75–85. [DOI] [PubMed]
Amantea D, Nappi G, Bernardi G, Bagetta G, Corasaniti MT. Post-ischemic brain damage: pathophysiology and role of inflammatory mediators.FEBS J. 2009;276:13–26. [DOI] [PubMed]
Mansoorali KP, Prakash T, Kotresha D, Prabhu K, Rama Rao N. Cerebroprotective effect of Eclipta alba against global model of cerebral ischemia induced oxidative stress in rats.Phytomedicine. 2012;19:1108–16. [DOI] [PubMed]
Béjot Y, Daubail B, Giroud M. Epidemiology of stroke and transient ischemic attacks: current knowledge and perspectives.Rev neurol (Paris). 2016;172:59–68. [DOI] [PubMed]
Diener HC, Hankey GJ. Primary and secondary prevention of ischemic stroke and cerebral hemorrhage: JACC focus seminar.J Am Coll Cardiol. 2020;75:1804–18. [DOI] [PubMed]
Tremonti C, Thieben M. Drugs in secondary stroke prevention.Aust Prescr. 2021;44:85–90. [DOI] [PubMed] [PMC]
Australian and New Zealand living clinical guidelines for stroke management–chapter 4 of 8: secondary prevention [Internet].Stroke Foundation; c2017 [cited 2017 Sep 7]. Available from: https://app.magicapp.org/#/guideline/7638
Karsy M, Brock A, Guan J, Taussky P, Kalani MY, Park MS. Neuroprotective strategies and the underlying molecular basis of cerebrovascular stroke.Neurosurgical Focus. 2017;42:E3. [DOI] [PubMed]
Shirley R, Ord EN, Work LM. Oxidative stress and the use of antioxidants in stroke.Antioxidants (Basel). 2014;3:472–501. [DOI] [PubMed] [PMC]
Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American college of cardiology/American heart association task force on clinical practice guidelines.Hypertension. 2018;71:e13–115.Erratum in: Hypertension. 2018;71:e140–4. [DOI] [PubMed]
Kalyanasundaram A, Lincoff AM, Medscape. Managing adverse effects and drug-drug interactions of antiplatelet agents.Nat Rev Cardiol. 2011;8:592–600. [DOI]
Newman CB, Preiss D, Tobert JA, Jacobson TA, Page RL 2nd, Goldstein LB, et al.; American Heart Association Clinical Lipidology, Lipoprotein, Metabolism and Thrombosis Committee, a Joint Committee of the Council on Atherosclerosis, Thrombosis and Vascular Biology and Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council. Statin safety and associated adverse events: a scientific statement from the american heart association.Arterioscler Thromb Vasc Biol. 2019;39:e38–81.Erratum in: Arterioscler Thromb Vasc Biol. 2019;39:e158. [DOI] [PubMed]
Laguna GA, Magraner HJ, Carbajal QD, Arruzazabala VL, Mas FR, García MM, inventor. A mixture of higher primary aliphatic alcohols, its obtention from sugar cane wax and its pharmacological uses.WO1993EP00007. 1993 Feb 25.
Arruzazabala ML, Carbajal D, Mas R, Molina V, Valdes S, Laguna A. Cholesterol-lowering effects of policosanol in rabbits.Biol Res. 1994;27:205–8. [PubMed]
Menéndez R, Arruzazabala L, Más R, Del Río A, Amor AM, González RM, et al. Cholesterol-lowering effect of policosanol on rabbits with hypercholesterolemia induced by a wheat starch-casein diet.Br J Nutr. 1997;77:923–32. [DOI] [PubMed]
Pons P, Más R, Illnait J, Fernández L, Rodríguez M, Robaina C, et al. Efficacy and safety of policosanol in patients with primary hypercholesterolemia.Curr Ther Res. 1992;52:507–13. [DOI]
Pons P, Jiménez A, Rodríguez M, Illnait J, Más R, Fernández L, et al. Effects of policosanol in elderly hypercholesterolemic patients.Curr Ther Res. 1993;53:265–9. [DOI]
Canetti M, Moreira M, Mas R, Illnait J, Fernandez L, Fernandez J, et al. A two-year study on the efficacy and tolerability of policosanol in patients with type II hyperlipoproteinaemia.Int J Clin Pharmacol Res. 1995;15:159–65. [PubMed]
Arruzazabala ML, Más R, Molina V, Carbajal D, Mendoza S, Fernández L, et al. Effect of policosanol on platelet aggregation in type II hypercholesterolemic patients.Int J Tissue React. 1998;20:119–24. [PubMed]
Menéndez R, Más R, Amor AM, Fernández JC, González RM. Effects of policosanol on the susceptibility of low-density lipoprotein isolated from hypercholesterolemic patients at high coronary risk to in vitro copper-mediated lipid peroxidation: a randomised, double-blinded pilot study.Curr Ther Res. 2000;61:609–20. [DOI]
Noa M, Más R, Lariot C. Protective effect of policosanol on endothelium and intimal thickness induced by forceps in rabbits.J. Med Food. 2007;10:452–9. [DOI] [PubMed]
Carbajal D, Arruzazabala ML, Valdés S, Más R. Interaction policosanol-warfarin on bleeding time and thrombosis in rats.Pharmacol Res. 1998;38:89–91. [DOI] [PubMed]
Hernández F, Illnait J, Más R, Castaño G, Fernández L, González M, et al. Effects of policosanol on serum lipids and lipoproteins in healthy volunteers.Curr Ther Res. 1992;51:568–75.
Arruzazabala ML, Valdés S, Más R, Fernández L, Carbajal D. Effect of policosanol succesive dose increases on platelet aggregation in healthy volunteers.Pharmacol Res. 1996;34:181–5. [DOI] [PubMed]
Orozco J, Gallardo R, Illnait J, Fernández L, Fábregas M, Más R, et al. Estudio de la eficacia, seguridad y tolerabilidad del policosanol (5 mg/day) en pacientes con hipercolesterolemia tipo II.Rev CENIC Cienc Biol. 1996;27:41–5. Spanish.
Castaño G, Canetti M, Moreira M, Tula L, Más R, Illnait J, et al. Efficacy and tolerability of policosanol in elderly patients with type II hypercholesterolemia: a 12-months study.Curr Ther Res. 1995;56:819–28. [DOI]
Delbarre G, Delbarre B, Casset-Senon D. The use of the Mongolian gerbil as a model for cerebrovascular involvement.Paroi Arterielle. 1980;6:161–5. French. [PubMed]
Jarrott DM, Domer FR. A gerbil model of cerebral ischemia suitable for drug evaluation.Stroke. 1980;11:203–9. [DOI] [PubMed]
Arruzazabala ML, Molina V, Carbajal D, Valdés S, Más R. Effect of policosanol on cerebral ischemia in Mongolian gerbils: role of prostacyclin and thromboxane A2.Prostaglandins, leukot Essent fatty acids. 1993;49:695–7. [DOI] [PubMed]
Szczuko M, Kozioł I, Kotlęga D, Brodowski J, Drozd A. The role of thromboxane in the course and treatment of ischemic stroke: review.Int J Mol Sci. 2021;22:11644. [DOI] [PubMed] [PMC]
Molina V, Arruzazabala ML, Carbajal D, Valdés S, Noa M, Mas R, et al. Effect of policosanol on cerebral ischemia in Mongolian gerbils.Braz J Med Biol Res. 1999;32:1269–76. [DOI] [PubMed]
Taylor MD, Palmer GC, Callahan AS 3rd. Protective action by methylprednisolone, allopurinol and indomethacin against stroke-induced damage to adenylate cyclase in gerbil cerebral cortex.Stroke. 1984;15:329–35. [DOI] [PubMed]
Oliver CN, Starke-Reed PE, Stadtman ER, Liu GJ, Carney JM, Floyd RA. Oxidative damage to brain proteins, loss of glutamine synthetase activity, and production of free radicals during ischemia/reperfusion-induced injury to gerbil brain.Proc Natl Acad Sci U S A. 1990;87:5144–7. [DOI] [PubMed] [PMC]
Fraga V, Menéndez R, Amor AM, González RM, Jiménez S, Más R. Effect of policosanol on in vitro and in vivo rat liver microsomal lipid peroxidation.Arch Med Res. 1997;28:355–60. [PubMed]
Menéndez R, Fraga V, Amor AM, González RM, Más R. Oral administration of policosanol inhibits in vitro copper ion-induced rat lipoprotein peroxidation.Physiol Behav. 1999;67:1–7. [DOI] [PubMed]
Molina V, Ravelo Y, Noa M, Mas R, Valle M, Pérez Y, et al. Therapeutic effects of policosanol and grape seed extract against global brain ischemia-reperfusion injury in gerbils.Lat Am J Pharm. 2013;32:113–9.
Katsuta K, Umemura K, Ueyama N, Matsuoka N. Pharmacological evidence for a correlation between hippocampal CA1 cell damage and hyperlocomotion following global cerebral ischemia in gerbils.Eur J Pharmacol. 2003;467:103–9. [DOI] [PubMed]
Lee JC, Won MH. Neuroprotection of antioxidant enzymes against transient global cerebral ischemia in gerbils.Anat Cell Biol. 2014;47:149–56. [DOI] [PubMed] [PMC]
Molina-Cuevas V, Ravelo-Calzado Y, Mena-Valdés L, Noa-Puig M, Pérez-Guerra Y, Oyarzábal-Yera A, et al. Efectos PREVENTIVOS del policosanol y el aceite de pescado omega-3 sobre la isquemia cerebral global en Mongolian gerbils.Rev CENIC Cienc Biol. 2015;46:1–8. Spanish.
Molina V, Ravelo Y, Mena L, Noa M, Guerra Y, Oyarzábal Yera A, et al. Therapeutic effects of policosanol and omega-3 fish oil against global brain ischemia reperfusion in Mongolian gerbils.Int J Pharm Sci Rev Res. 2017;42:179–85.
Molina V, Ravelo Y, Noa M, Mas R, Pérez Y, Oyarzábal A, et al. Therapeutic effects of policosanol and atorvastatin against global brain ischemia-reperfusion injury in gerbils.Indian J Pharm Sci. 2013;75:635–41. [DOI] [PubMed] [PMC]
Ortega LL, Sánchez J, Más R, Fernández L, Mendoza S, Gámez R, et al. Effects of policosanol on patients with ischemic stroke: a pilot open study.J Med Food. 2006;9:378–85. [DOI] [PubMed]
Sánchez J, Mas R, Mendoza S, Fernández JC, Ruiz D. Effects of policosanol on patients with ischemic stroke with previous transient ischemic attack: a long-term follow-up.Rev CENIC Ciencias Biológicas. 2010;41:23–9.
Sánchez J. Effects of policosanol on the recovery of ischemic stroke: a randomized controlled study.IOSR J Pharm. 2012;2:14–24.
Ciancarelli I, De Amicis D, Di Massimo C, Carolei A, Ciancarelli MG. Oxidative stress in post-acute ischemic stroke patients after intensive neurorehabilitation.Curr Neurovasc Res. 2012;9:266–73. [DOI] [PubMed]
Laloux P. Risk and benefit of statins in stroke secondary prevention.Curr Vasc Pharmacol. 2013;11:812–6. [DOI] [PubMed]
Sánchez J, Illnait J, Mas R, Mendoza S, Vega H, Fernández JC, et al. Policosanol versus atorvastatin on the functional recovery of patients with ischemic stroke.Int J Phar Sci Rev Res. 2016;37:7–14.