Journal article
Uric acid therapy improves the outcomes of stroke patients treated with intravenous tissue plasminogen activator and mechanical thrombectomy
International journal of stroke, Vol.12(4), pp.377-382
06/2017
DOI: 10.1177/1747493016684354
PMID: 28345429
Abstract
Background Numerous neuroprotective drugs have failed to show benefit in the treatment of acute ischemic stroke, making the search for new treatments imperative. Uric acid is an endogenous antioxidant making it a drug candidate to improve stroke outcomes. Aim To report the effects of uric acid therapy in stroke patients receiving intravenous thrombolysis and mechanical thrombectomy. Methods Forty-five patients with proximal vessel occlusions enrolled in the URICO-ICTUS trial received intravenous recombinant tissue plasminogen activator within 4.5 h after stroke onset and randomized to intravenous 1000 mg uric acid or placebo (NCT00860366). These patients also received mechanical thrombectomy because a brain computed tomogaphy angiography confirmed the lack of proximal recanalization at the end of systemic thrombolysis. The primary outcome was good functional outcome at 90 days (modified Rankin Score 0-2). Safety outcomes included mortality, symptomatic intracerebral bleeding, and gout attacks. Results The rate of successful revascularization was >80% in the uric acid and the placebo groups but good functional outcome was observed in 16 out of 24 (67%) patients treated with uric acid and 10 out of 21 (48%) treated with placebo (adjusted Odds Ratio, 6.12 (95% CI 1.08-34.56)). Mortality was observed in two out of 24 (8.3%) patients treated with uric acid and one out of 21 (4.8%) treated with placebo (adjusted Odds Ratio, 3.74 (95% CI 0.06-226.29)). Symptomatic cerebral bleeding and gout attacks were similar in both groups. Conclusions Uric acid therapy was safe and improved stroke outcomes in stroke patients receiving intravenous thrombolysis followed by thrombectomy. Validation of this simple strategy in a larger trial is urgent.
Details
- Title: Subtitle
- Uric acid therapy improves the outcomes of stroke patients treated with intravenous tissue plasminogen activator and mechanical thrombectomy
- Creators
- Ángel Chamorro - 1 Hospital Clinic, Barcelona, SpainSergio Amaro - 1 Hospital Clinic, Barcelona, SpainMar Castellanos - 2 Complejo Hospitalario Universitario A Coruña, A Coruña, SpainMeritxell Gomis - 3 Hospital Germans Trias i Pujol, Badalona, SpainXabier Urra - 1 Hospital Clinic, Barcelona, SpainJordi Blasco - 1 Hospital Clinic, Barcelona, SpainJuan F Arenillas - 4 Hospital Universitario of Valladolid, Valladolid, SpainLuis S Román - 1 Hospital Clinic, Barcelona, SpainRoberto Muñoz - 5 Hospital of Navarra, Pamplona, SpainJuan Macho - 1 Hospital Clinic, Barcelona, SpainDavid Cánovas - 6 Hospital Parc Taulí, Sabadell, SpainJoan Marti-Fabregas - 7 Hospital de Sant Pau, Barcelona, SpainEnrique C Leira - 8 University of Iowa Carver College of Medicine, Iowa City, USAAnna M Planas - 9 Institute for Biomedical Research of Barcelona (IIBB), Barcelona, Spain
- Resource Type
- Journal article
- Publication Details
- International journal of stroke, Vol.12(4), pp.377-382
- Publisher
- United States
- DOI
- 10.1177/1747493016684354
- PMID
- 28345429
- ISSN
- 1747-4930
- eISSN
- 1747-4949
- Language
- English
- Date published
- 06/2017
- Academic Unit
- Neurology; Epidemiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984070341802771
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