Uric Acid Levels Are Relevant in Patients With Stroke Treated With Thrombolysis

Abstract

Background and Purpose-Uric acid (UA) is a neuroprotective antioxidant that improves the benefits of alteplase in experimental ischemia. However, it is unknown whether endogenous UA also influences the response to thrombolysis in patients with stroke. Methods-A total of 317 consecutive patients treated with thrombolysis were included in a prospective stroke registry.Demographics, laboratory data, neurological course, and infarction volume were prospectively collected. Excellent outcome was defined as achieving a modified Rankin Scale score Ͻ2 at 90 days. Binary and ordinal logistic regression models were used to analyze modified Rankin Scale score at 90 days. Results-UA levels were significantly higher in patients with an excellent outcome than in patients with a poor outcome (5.

A Study of Serum Uric Acid Levels in Acute Ischemic Stroke Patients Admitted in Tertiary Care Hospital At Tirupati

“…3,4 UA is one of most important antioxidants in serum and appears to be neuroprotecive in animal models, the results from human studies are controversial. 7 Serum UA levels would change noticeably in association with degree of oxidative stress in acute ischemic stroke.…”

Translational Stroke Research of the Combination of Thrombolysis and Antioxidant Therapy

“…45 Higher UA levels at stroke admission are associated with better outcome and less infarction growth at follow-up, and these effects have been found in patients treated or not with thrombolytic therapy. 46,47 In patients receiving rtPA, lower UA levels are associated with a greater incidence of malignant middle cerebral artery infarctions and/or hemorrhagic transformation of the infarction. 47 In a Phase II placebocontrolled trial, 44 the combination of UA and rtPA was safe and prevented an early fall of circulating UA levels.…”

“…46,47 In patients receiving rtPA, lower UA levels are associated with a greater incidence of malignant middle cerebral artery infarctions and/or hemorrhagic transformation of the infarction. 47 In a Phase II placebocontrolled trial, 44 the combination of UA and rtPA was safe and prevented an early fall of circulating UA levels. 44 UA also prevented an increment of malondialdehyde and active (a)-MMP-9 in rtPA-treated patients, and these biomarkers were found inversely correlated with stroke outcome at 3 months.…”

Proceedings of Recent Developments and Future Directions in Stroke Management and Prevention Symposium

“…7 By the same token, significantly lower levels of uric acid were found in patients with malignant MCA infarction and parenchymal hemorrhage after thrombolysis. These data support the role of oxidative stress in patients with acute stroke and provide solid arguments for a future formal trial of exogenous uric acid plus alteplase.…”