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Susan Fagan, Pharm.D., BCPS, FCCP

Albert W. Jowdy Professor

Distinguished Research Professor

Interim Director IPE

Assistant Dean, Augusta University Program

Augusta, GA

Office: HM, Rm 116   
Voice: 706-721-0130
Fax: 706-721-3994

Education

BSc Pharm , Dalhousie 1980

Pharm.D. , SUNY 1984

Fellowship(Neuropharm) , Dent Neurologic Inst. 1986

Research Interests

Stroke Pharmacotherapy; animal models of ischemic stroke; hemorrhagic transformation; vascular protection after stroke; angiogenesis after stroke; stroke outcomes

Grant Support

Current research funded by NIH R01 & VA Merit Review

Received $12,144 from Georgia Regents University for study of vascular injury and protection in diabetic stroke recovery

Received $319,000 from the National Institutes of Health to study angiotensin receptor agonism to promote recovery after stroke.

Of Note

Awards

Received a Seed Grant (2014)
Distinguished Research Professor (2013)
Jowdy Professor of Pharmacy Care (2008)

 

Editorial Boards

Editorial Board, Journal of Stroke and Cerebrovascular Disease; 1996 - 2000

Section Editor, Journal of Informed Pharmacotherapy; 1999-2004

Editorial Board, Pharmacotherapy Self-Assessment Program (fourth edition); 1999-2002

Editorial Board, Annals of Pharmacotherapy; 2000 – 2008

Editorial Board, Pharmacotherapy; 2001 - pres

Editorial Board, Pharmacotherapy Self-Assessment Program (fifth edition); 2002 – 2005

Editorial Board, Clotcare.com: 2007 – present

Translational Stroke Research: 2011 - present

 

Study Sections

American Heart Association – National; Brain 1 Study Section; 2002 - 2006

NIH – NINDS Special Emphasis Panel: ZNS1 SRB-K (20); 2004

NIH – NINDS: ZRG1-BDCNL-90: Brain injury and neurovascular pathologies; 2005- 2006

ACCP Research Institute; CNS Investigator Development Award Panel; 2005

NIH – NINDS: NSD-K: Pilot Clinical trials; 2005 – 2007

NIH -NINDS: ZNS1 SRB-M (28); 2005

NIH – NINDS: ZNS1 SRB-M (30); 2005

NIH – NINDS: ZNS1K-44; 2006

NIH – NINDS: ZNS1 SRB G(20) Stroke SEP Review; 2007

NIH – NINDS: NSD-K: Clinical trials; 2008 – 2011

American Heart Association – National; Brain 2 Study Section; 2009

NIH-NINDS: NSD-C: Neurology C (ad hoc): October, 2011

Selected Publications

Brott TG, Grotta JC, Latchaw RE, Starkman S, Jauch E, Clark WM, Fagan SC, Hopkins LN: Stroke The First Hours. Consensus Statement. October, 2000; National Stroke Association

Fagan SC: Hemorrhagic transformation after reperfusion therapy for acute ischemic stroke. J Inform Pharmacother (online) 2001;4:300-305

Grotta JC, Welch KMA, Fagan SC, Lu M, Frankel MR, Brott T, Levine SR, Lyden PD and the NINDS rt-PA Stroke Study Group. Clinical deterioration following improvement in the NINDS rt-PA Stroke Trial. Stroke 2001;32:661-668

Lyden P, Lu M, Kwiatkowski T, Frankel M, Levine S, Broderick J, Brott T and the NINDS rt-PA Stroke Study Group: Thrombolysis in patients with transient neurologic deficits. Neurology 2001;57:2125-2128

Ravina BM, Fagan SC, Hart RG, Hovinga CA, Murphy DD, Dawson TM, Marler JR: Neuroprotective agents for clinical trials in Parkinson’s Disease: A systematic assessment. Neurology 2003; 60: 1234

Fagan SC, Nagaraja TN, Fenstermacher JD, Zheng J, Johnson M, Knight RA: Hemorrhagic transformation is related to the duration of occlusion and treatment with tissue plasminogen activator in a non-embolic stroke model. Neurol Res 2003; 25:  377-382

Hilali HM, Simpkins AN, Hill WD, Waller JL, Knight RA, Fagan SC: Single slice method for quantification of hemorrhagic transformation using Direct ELISA. Neurol Res 2004; 26:93-98

Fagan SC, Edwards DJ, Borlongan C, Xu L, Arora A, Feuerstein G, Hess DC. Optimal delivery of minocycline to the brain. Implication for human studies of acute neuroprotection. Exp Neurol 2004;186:248-251

Xu L, Fagan SC, Waller JL, Edwards D, Borlongan CV, Zheng J, Hill WD, Feuerstein G, Hess DC. Low-dose intravenous minocycline is neuroprotective after middle cerebral artery occlusion-reperfusion in rats. BMC Neurology 2004; 4:7

Fagan SC, Hess DC, Pollock DM, Hohnadel EJ, Ergul A. Targets for vascular protection after ischemic stroke. Stroke 2004; 35:35:2220-2225

Fagan SC, Hess DC, Machado LS, Hohnadel EJ, Pollock DM, Ergul A. Tactics for vascular protection after acute ischemic stroke. Pharmacotherapy 2005;25(3): 387-395

Knight RA, Nagesh V, Nagaraja TN, Ewing JR, Nagesh V, Whitton PA, Bershad E, Fagan SC, Fenstermacher JD. Acute blood-brain barrier opening in experimentally induced focal cerebral ischemia is preferentially identified by quantitative magnetization transfer imaging. Magn Reson Med 2005;54(4):822-832

Harris AK, Ergul A, Kozak A, Machado LS, Johnson MH, Fagan SC: Effect of neutrophil depletion on gelatinase expression, edema formation and hemorrhagic transformation after focal ischemic stroke. BMC Neuroscience, 2005; 6:49

Fagan SC, Kozak A, Hill WD, Pollock DM, Xu L, Johnson MH, Ergul A, Hess DC: Hypertension after experimental cerebral ischemia: candesartan provides neurovascular protection. J Hypertens 2006;24:535-539

Elewa HF, Hilali H, Hess DC, Machado LS, Fagan SC: Minocycline for short-term neuroprotection. Pharmacotherapy 2006; 26(4):515-521

Machado LS, Kozak A, Ergul A, Hess DC, Borlongan CV, Fagan SC: Delayed minocycline inhibits ischemia-activated MMP 2 and 9 after experimental stroke. BMC Neuroscience 2006;7:56

Elewa HF, Kozak A, Johnson MH, Ergul A, Fagan SC: Blood pressure lowering after experimental cerebral ischemia provides neurovascular protection. J Hypertens 2007; 25: 855-859

Ergul A, Elgebaly MM, Middlemore ML, Li W, Switzer JA, Hall C, Kozak A, Fagan SC. Increased Hemorrhagic Transformation And Altered Infarct Size And Localization After Experimental Stroke In A Rat Model of Type 2 Diabetes. BMC Neurology 2007: 7:33

Kozak W, Kozak A, Elewa HF, Johnson MH, Fagan SC: Vascular protection with candesartan after experimental acute stroke in hypertensive rats: A dose-response study.  J Pharmacol Exp Ther 2008; DOI: 10.1124/jpet.108.139618

Kozak A, El-Remessy AB, Ergul A, Machado LS, Elewa HF, Johnson MH, Abdelsaid M, Wiley DA, Fagan SC. Candesartan augments ischemia-induced proangiogenic state and results in sustained functional improvement after stroke. Stroke 2009; 40:1870

Ergul A, Elgebaly M, Li W, Bruno A, Fagan SC: Hyperglycemia, diabetes and stroke: Focus on the cerebrovasculature. Vascular Pharmacol 2009; 51;44-49

Elewa HF, Kozak A, Frye RF, Johnson MH, Ergul A, Fagan SC: Early atorvastatin reduces hemorrhage after acute cerebral ischemia in diabetic rats. J Pharmacol Exp Ther 2009; May 28; epub ahead of print

Machado LS, Sazanova I, Kozak A, Wiley DC, El-Remessy AB, Ergul A, Hess DC, Fagan SC. Minocycline and tissue plasminogen activator for stroke: Assessment of Interaction potential. Stroke 2009; 40: 3028-3033

Li W, Kelly AI, El-Remessy A, Schreihofer DA, Kozak A, Dorrance AM, Fagan SC, Ergul A. Effects of type 2 diabetes on vascular density, integrity and function of the cerebrovasculature: relevance to focal cerebral ischemia. Diabetes 2010;59(1):228-235

Elewa HF, El-Remessy AB, Somanath PR, Fagan SC: Diverse Effects of Statins on Angiogenesis Open New Therapeutic Avenues. Pharmacotherapy 2010;30(2):169-176

Hess DC, Fagan SC. Repurposing and old drug to improve the safety and use of tissue plasminogen activator for acute ischemic stroke: minocycline. Rev Neurol Dis 2010; 7(suppl 1): S7-S13

Fagan SC. Drug repurposing for drug development in stroke. Rev Neurol Dis 2010;7(suppl 1):S3-S6

Fagan SC. Old drugs, new tricks: Update on stroke therapeutics. Rev Neurol Dis 2010;7(suppl 1):S1-S2

Lees KR, Bluhmki E, von Kummer R, Brott TG, Toni D, Grotta JC, Albers GW, Kaste M, Marler JR, Hamilton SA, Tilley BC, Davis SM, Donnan GA, Hacke W; ECASS, ATLANTIS, NINDS and EPITHET rt-PA Study Group, Allen K, Mau J, Meier D, del Zoppo G, De Silva DA, Butcher KS, Parsons MW, Barber PA, Levi C, Bladin C, Byrnes G. Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Lancet. 2010 May 15;375:1695-703

Fagan SC, Waller JL, Nichols FT, Edwards DJ, Pettigrew LC, Clark W, Hall C, Switzer JA, Ergul A, Hess DC. Minocycline to Improve Neurologic Outcome in Stroke (MINOS): A dose finding study. Stroke 2010; 41:2283-2287

Elgebaly MM, Prakash R, Li W, Ogbi S, Johnson MH, Mezzetti EM, Fagan SC, Ergul A. Vascular protection in diabetic stroke: Role of matrix metalloprotease-dependent vascular remodeling. J Cerebral Blood Flow Metab 2010;120: 1-11

Fagan SC. Commentary (Invited): Measuring disease-free life after thrombolysis. Nat Rev Neurol 2010; 6:361-362

Li W, Kelly-Cobbs AI, Mezzetti EM, Fagan SC, Ergul A. Endothelin-1-mediated cerebrovascular remodeling is not associated with increased ischemic brain injury in diabetes. Can J Physiol Pharmacol 2010;Aug; 88(8):788-795

Bushnell CD, Zimmer LO, Pan W, Olson DM, Zhao X, Meteleva T, Schwamm L, Ovbiogele B, Williams L, LaBresh KA, Peterson ED, for the Adherence Evaluation after Ischemic Stroke – Longitudinal Investigators. Persistence with stroke prevention medications 3 months after hospitalization. Arch Neurol 2010;67:1456-1463

Willis, LM, Somanath PR, El-Remessy AB, Deremer DL, Fagan SC. Angiotensin receptor antagonists and angiogenesis: Clinical and Experimental Evidence. Clinical Science 2011; 120(8): 307-319

Furie KL, Kasner SE, Adams RJ, Albers G, Bush RL, Fagan SC, Halperin J, Johnson SC, Katzan I, Kernan WN, Mitchell P, Obviagele B, Palesch Y, Sacco RL, Schwamm LH, Wassertheil-Smoller S, Turan T, Wentworth D. Guidelines for the prevention of stroke in patients with ischemic stroke or transient ischemic attack. Stroke 2011;42(1):227-76

Guan W, Kozak A, El-Remessy AB, Johnson MH, Fagan SC. Acute treatment with candesartan reduces early injury after permanent middle cerebral artery occlusion. Translational Stroke Research 2011: 2(2): 179-185

Switzer JA, Hess DC, Waller JL, Ergul A, Portik-Dobos V, Machado LS, Fagan SC. MMP 9 in an exploratory trial of intravenous minocycline for acute ischemic stroke. Stroke 2011; 42: 2633-2635

Fagan SC, Cronic LE, Hess DC. Minocycline development for acute ischemic stroke (Invited). Translational Stroke Research 2011;2(2):202

Guan W, Kozak A, Fagan SC. Drug repurposing for vascular protection after acute ischemic stroke. Acta Neurochir Supp 2011; 49:295-298

Alhusban A, Fagan, SC. Secondary Stroke Prevention in the Elderly (invited). Am J Ger Pharmacother 2011; 9(3):143-152

Bushnell CD, Olson DWM, Zhao X, Pan W, Zimmer LO, Alberts MJ, Fagan SC, Fonarow GC, Frankel M, Johnston SC, Kidwell C, LaBresh KA, Ovbiagele B, Schwamm L and Peterson ED for the AVAIL investigators. Secondary Preventive Medication Persistence and Adherence One-Year After stroke: Results from AVAIL. Neurology 2011; 77:1182-1190

Elgebaly MM, Ogbi S, Li W, Mezzetti E, Prakash R, Johnson MH, Bruno A, Fagan SC, Ergul A. Neurovascular outcomes in acute hyperglycemia and diabetes: A comparative analysis in experimental stroke. Translational Stroke Research 2011; 2(3):391-398

Guan W, Somanath PR, Kozak A, Goc A, El-Remessy AB, Ergul A, Johnson MH, Alhusban A, Soliman S, Fagan SC. Vascular protection by angiotensin receptor antagonism involves differential VEGF expression in both hemispheres after stroke. Plos One 2011; 6(9): e24551

Wrotek S, Kozak W, Hess DC, Fagan SC. Fever following stroke: Conflicting evidence regarding treatment. Pharmacotherapy 2011;31(11):1085-1091

Prakash R, Johnson M, Fagan SC, Ergul A.Cerebral neovascularization and remodeling patterns in two different models of type 2 diabetes. PLoS One. 2013;8(2):e56264.

Baker WL, Marrs JC, Davis LE, Nutescu EA, Shaun Rowe A, Ryan M, Splinter MY, Vardeny O, Fagan SC. Key Articles and Guidelines in the Primary Prevention of Ischemic Stroke. Pharmacotherapy. 2013 Feb 11.

Baker WL, Marrs JC, Davis LE, Nutescu EA, Rowe AS, Ryan M, Splinter MY, Vardeny O, Fagan SC. Key Articles and Guidelines in the Acute Management and Secondary Prevention of Ischemic Stroke. Pharmacotherapy. 2013 Feb 11.

Kelly-Cobbs AI, Prakash R, Li W, Pillai B, Hafez S, Coucha M, Johnson MH, Ogbi SN, Fagan SC, Ergul A. Targets of vascular protection in acute ischemic stroke differ in type 2 diabetes. Am J Physiol Heart Circ Physiol. 2013 Mar;304(6):H806-15.

Lio TV, Forehand CC, Hess DC, Fagan SC, "Minoclyine repurposing in critical illness: Focus on stroke" Curr Top Med Chem 2013; 13(18)

Prakash R, Li W, Qu Z, Johnson MH, Fagan SC, Ergul A, "Vascularization Pattern after ischemic stroke is different in control versus diabetic rats: Relevance to stroke recovery" Stroke 2013; 44(10):2875-2882.

Li W, Qu Z, Ma H, Prakash R, Chung C, Hoda N, Fagan SC, Ergula A. "Comparative analysis of the neurovascular injury and functional outcomes in experimental stroke models in diabetic Goto-Kakizaki ratis." Brain Res 2013; Oct 18. 

Abdalla M, Goc A, Segar l, Ergul EA, Fagan SC, Somanath Shenoy. "Tribicine, a Selective Akt Inhibitior, Ameliorates Idiopathic Pulmonary Fibrosis and Pulmonary Hypertension."

Fagan SC, Patel A, Solieman S. "Effect of Minocycline on the proagiogenic Effect of Candesartan in Human Brain Endothelial Cells."

Ergul A, Abdeksaid M, Fouda A, Fagan Sc. "Cerebral neovascularization in diabetes: Implications for stroke recoveryand beyond." Invited review, J Cerebr Blood Flow Metab; Feb 5; doi:10.1038/jcbfm.2014.18. (Featured on the cover)

Fagan SC

Had a record ten papers presentated at the International Stroke Conference in San Diego, CA; Feb 11-14.

  1. Alhusban A, Fouda A, Pillai B, Ergul A, Fagan SC. BDNF knockdown abrogates AT1 blockade-induced improvement in stroke outcome.
  2. Qu Z, Li W, Prakash R, Fagan SC, Ergul A. Diet-induced diabetes impairs neovascularization and functional recovery after ischemic stroke. 
  3. Ishrat T, El-Remessy AB, Pillai B, Soliman S, Ergul A, Fagan SC. Thioredoxin interacting protein: A novel target for neuroprotection in expertimental thromboembolic stroke in mice. 
  4. Hoda MN, Khan M, Wakade C, Ergul A, Fagan SC, Hess DC. Remote ischemic conditioning (RIC), a combined regimen of Per- and Post- conditionings (RIPerC and RIPostC), proveides long-term motor and cognitive benefits in murine embolic stroke model (eMCAO).
  5. Coucha M, Li W Abdelsaid M, Hafez S, Fagan SC, Ergul A. The impact method of ischemia/reperfusion injury on stroke outcome in type 2 diabetes. 
  6. Li W, Ma H, Prakash R, Fagan SC, Ergul A. The impact of method of ischemia/reperfusion injury on stroke outcome in type 2 diabetes. 
  7. Hafez S, Abdelsaid M, Coucha M, Fagan SC, Ergul A. Matrix metalloproteinase 3 (MMP3) exacerbates the hemorrhagic transformation in hyperglycemic stroke. 
  8. Soliman S, Ishrat T, Patel A, Fouda A, Ergul A, Fagan SC. Sequential treatment with minoclyine and candesartan improves long term recovery after stroke. 
  9. Boudreau DM, Guzauskas GF, Tayama D, Fagan SC, Veenstra DL. An updated cost-effectiveness analysis of rtPA for actute ischemic stroke treated within 3 hours of symptom onset. 
  10. Abdelsaid M, Prakash R, Li W, Coucha M, Fagan SC, Ergul A. The role of ischemia/reperfusion generated nitrative stress on VEGF angiogenic signaling in dabetic rats.

Alhusban A*, Fouda AY*, Pillai B, Ishrat T, Soliman S, Fagan SC. C21 is proangiogenic in the brain and results in sustained recovery after ischemic stroke. J Hypertension, epub ahead of print, October 8, 2014

Affiliations

Current Graduate Students