title: Uric acid levels are relevant in patients with stroke treated with thrombolysis.
abstract: OBJECTIVE
  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 <2 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 (5.82 [1.39] versus 5.42 [1.81], P=0.029). In multivariate models, increased UA levels (OR, 1.23; 95% CI, 1.03 to 1.49; P=0.025) were associated with an excellent outcome and with an increased risk of shifting to a better category across the modified Rankin Scale (OR, 1.19; 95% CI, 1.04 to 1.38; P=0.014) independently of the effect of confounders. The levels of UA and the volume of final infarction were inversely correlated (r=-0.216, P<0.001) and the inverse correlation remained after adjustment for age, sex, and baseline National Institutes of Health Stroke Scale score (t value=-2.54, P=0.01). Significantly lower UA levels were found in patients with malignant middle cerebral artery infarction and parenchymal hemorrhage post-thrombolysis.
  
  
  CONCLUSIONS
  Increased UA serum levels are associated with better outcome in patients with stroke treated with reperfusion therapies. These results support the assessment of the potential neuroprotective role of the exogenous administration of UA in patients with stroke treated with thrombolysis.
authors.affiliation: Stroke Unit, Institute of Neurosciences, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Amaro
authors.forename: Xabier
authors.initials: X
authors.lastname: Urra
authors.forename: Manuel
authors.initials: M
authors.lastname: Gómez-Choco
authors.forename: Víctor
authors.initials: V
authors.lastname: Obach
authors.forename: Alvaro
authors.initials: A
authors.lastname: Cervera
authors.forename: Martha
authors.initials: M
authors.lastname: Vargas
authors.forename: Ferran
authors.initials: F
authors.lastname: Torres
authors.forename: Jose
authors.initials: J
authors.lastname: Rios
authors.forename: Anna M
authors.initials: AM
authors.lastname: Planas
authors.forename: Angel
authors.initials: A
authors.lastname: Chamorro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000378:metabolism; D011446:Prospective Studies; D012042:Registries; D015424:Reperfusion; D012189:Retrospective Studies; D015996:Survival Rate; D015912:Thrombolytic Therapy; D014527:Uric Acid / Q000097:blood*
chemical_list: D000975:Antioxidants; D018696:Neuroprotective Agents; D014527:Uric Acid