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All Journal International Journal of Public Health Science (IJPHS) JURNAL GIZI INDONESIA Jurnal Kebijakan Kesehatan Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Mutiara Medika: Jurnal Kedokteran dan Kesehatan Majalah Farmaseutik Amerta Nutrition Callosum Neurology Journal : Jurnal Berkala Neurologi Bali Majalah Kedokteran Neurosains Jurnal Biogenerasi JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Berita Kedokteran Masyarakat Prosiding SNPBS (Seminar Nasional Pendidikan Biologi dan Saintek) Neurona
Ismail Setyopranoto
Departemen Neurologi, FK-KMK Universitas Gadjah Mada/RSUP Dr. Sardjito, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Journal : Neurona

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PERAN LABELATOL DALAM MANAJEMEN HIPERTENSI EMERGENSI PADA STROKE AKUT Setyopranoto, Ismail; Gofir, Abdul; Paryono
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 5: Edisi Suplemen Neurona Bekerjasama dengan JogjaCLAN 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i5.862

Abstract

APLIKASI KLINIS N-ACETYLCYSTEINE PADA STROKE ISKEMIK AKUT Setyopranoto, Ismail; Aifa, Bardatin Lutfi; Satiti, Sekar
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 5: Edisi Suplemen Neurona Bekerjasama dengan JogjaCLAN 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.872

Abstract

Pharmacological strategies to enhance reperfusion in acute ischemic stroke currently rely on the use of recombinant tissue plasminogen activator (rtPA), which acts by activating the fibrinolytic cascade. Although its clinical efficacy has been well established, rtPA does not significantly affect the non-fibrin components of thrombi, resulting in relatively low rates of early arterial recanalization (~30%), particularly in cases involving platelet-rich clots. Furthermore, rtPA increases the risk of intracerebral hemorrhage, thereby limiting its overall benefit–risk ratio. Consequently, alternative thrombolytic agents capable of dissolving arterial thrombi without elevating bleeding risk are urgently needed. Von Willebrand factor (vWF) plays a pivotal role in primary hemostasis, and elevated plasma vWF levels are associated with an increased risk of arterial thrombosis. Therapeutic strategies targeting vWF offer a novel approach to lysing platelet-rich thrombi, as their mechanisms operate independently of conventional platelet activation pathways. During arterial thrombosis, vWF multimers mediate platelet cross-linking; thus, proteolysis of vWF has the potential to disrupt platelet-rich thrombi and restore cerebral blood flow. N-acetylcysteine (NAC) cleaves disulfide bonds within vWF multimers, promoting thrombus dissolution and enhancing arterial recanalization. Compared with conventional antithrombotic agents, NAC demonstrates a superior safety profile, even in hemorrhagic stroke models, making it a promising therapeutic candidate for acute ischemic stroke. Moreover, NAC exhibits antioxidant, anti-inflammatory, and neuroprotective effects that support neuronal recovery and improve functional outcomes. Therefore, intravenous NAC may provide dual benefits—as an effective, safe, and affordable thrombolytic and neuroprotective agent—particularly in populations with limited access to rtPA. Keywords: N-acetylcysteine, von Willebrand factor, thrombolytic, neuroprotectant, acute ischemic stroke
Co-Authors Abdul Gofir Ahmad Asmedi Aifa, Bardatin Lutfi AKICHIKA MIKAMI Anton Darmawan Cempaka Thursina Christantie Effendy Desin Pambudi Sejahtera Desin Pambudi Sejahtera Dewa Ayu Citra Mahardina Dhite Bayu Nugroho Ditha Praritama Sebayang Emi Tamaroh Fadhila Pratamasari Farah Faza Fatwa Sari Tetra Dewi Hayati, Hanifah Fajarisna Hermawan Hanjaya Herni Astuti Indarwati Indarwati Indarwati Setyaningsih Indarwati Setyaningsih Indra Sari Kusuma Harahap John Kenedi Kusumo Dananjoyo Laksono Trisnantoro Lily Arsanti Lestari Mawaddah Ar-Rochmah Muhammad Dahlan Muhammad Ridha Afdhal Afdhal Nur Chayati Paryono Paryono Paryono Probosuseno Probosuseno Punik Mumpuni Wijayanti Rahman Rahman Ratih Rakasiwi Samekto Wibowo Satiti, Sekar Sekar Satiti Sekar Satiti Soebijanto Soebijanto Sri Sutarni Sri Sutarni Subagya Subagya, Subagya Supriyati Susetyowati Tri Ratnaningsih Umi Budi Rahayu Umi S. Intansari Ida Savitri Laksanawati Wibo, Samekto Zullies Ikawati