Uric Acid Therapy Improves Clinical Outcome in Women With Acute Ischemic Stroke

BACKGROUND AND PURPOSE—It is unknown whether women and men with acute ischemic stroke respond similar to an antioxidant regimen administered in combination with thrombolysis. Here, we investigated the independent effect of sex on the response to uric acid (UA) therapy in patients with acute stroke t...

Full description

Saved in:
Bibliographic Details
Published in:Stroke (1970) 2015-08, Vol.46 (8), p.2162-2167
Main Authors: Llull, Laura, Laredo, Carlos, Renú, Arturo, Pérez, Belén, Vila, Elisabet, Obach, Víctor, Urra, Xabier, Planas, Anna, Amaro, Sergio, Chamorro, Ángel
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antioxidants - therapeutic use
Brain Ischemia - diagnosis
Brain Ischemia - drug therapy
Double-Blind Method
Female
Humans
Male
Middle Aged
Sex Factors
Stroke - diagnosis
Stroke - drug therapy
Tissue Plasminogen Activator - therapeutic use
Treatment Outcome
Uric Acid - therapeutic use
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BACKGROUND AND PURPOSE—It is unknown whether women and men with acute ischemic stroke respond similar to an antioxidant regimen administered in combination with thrombolysis. Here, we investigated the independent effect of sex on the response to uric acid (UA) therapy in patients with acute stroke treated with alteplase. METHODS—In the Efficacy Study of Combined Treatment With Uric Acid and rtPA in Acute Ischemic Stroke (URICO-ICTUS) trial, 206 women and 205 men were randomized to UA 1000 mg or placebo. In this reanalysis of the trial, the primary outcome was the rate of excellent outcome at 90 days (modified Rankin Scale, 0–1, or 2, if premorbid score of 2) in women and men using regression models adjusted for confounders associated with sex. The interaction of UA levels by treatment on infarct growth was assessed in selected patients. RESULTS—Excellent outcome occurred in 47 of 111 (42%) women treated with UA, and 28 of 95 (29%) treated with placebo, and in 36 of 100 (36%) men treated with UA and 38 of 105 (34%) treated with placebo. Treatment and sex interacted significantly with excellent outcome (P=0.045). Thus, UA therapy doubled the effect of placebo to attain an excellent outcome in women (odd ratio [95% confidence interval], 2.088 [1.050–4.150]; P=0.036), but not in men (odd ratio [95% confidence interval], 0.999 [0.516–1.934]; P=0.997). The interactions between treatment and serum UA levels (P
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.115.009960