title: Serum uric acid is neuroprotective in Chinese patients with acute ischemic stroke treated with intravenous recombinant tissue plasminogen activator.
abstract: BACKGROUND
  Exogenous uric acid (UA) is a neuroprotective antioxidant that reinforces the benefits of intravenous recombinant tissue plasminogen activator thrombolysis in animal thromboembolic stroke. However, whether serum uric acid (SUA) also increases the benefits of thrombolysis in Chinese patients with acute ischemic stroke (AIS) has yet to be fully defined.
  
  
  METHODS
  A total of 216 consecutive AIS patients of Chinese origin treated with intravenous thrombolysis were enrolled in a prospective stroke registry. Demographic and clinical characteristics, conventional risk factors, important laboratory data, and neurologic course were prospectively recorded. Functional outcomes were assessed with the modified Rankin Scale (mRS) score on day 90 by telephone calls. Receiver operating characteristic curves and binary logistic regression models were used to examine the performance of SUA in predicting excellent outcomes (mRS, 0-1).
  
  
  RESULTS
  SUA levels were significantly higher in patients with excellent outcomes than those in patients with poor outcomes (331.46 ± 103.39 versus 277.69 ± 105.62, P = .008). SUA had a modest power for predicting excellent outcomes as suggested by area under the curve of .665 ± .052, P = .003. In multivariate models, increased SUA levels (adjusted odds ratio, 1.005; 95% confidence interval, 1.002-1.009; P = .033) were associated with excellent outcomes independently of the effect of possible confounders. Spearman correlation tests indicated that there was an inverse correlation between SUA levels and stroke severity.
  
  
  CONCLUSIONS
  Increased SUA levels are associated with excellent outcomes in Chinese patients with AIS treated with intravenous thrombolysis, giving additional support to administration of exogenous UA as an adjuvant to thrombolysis.
authors: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Xuan
authors: X
authors: Liu
authors: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Ming
authors: M
authors: Liu
authors: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Miao
authors: M
authors: Chen
authors: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Qin-Min
authors: QM
authors: Ge
authors: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. Electronic address: drshumingpan@hotmail.com.
authors: Shu-Ming
authors: SM
authors: Pan
mesh_terms: D000368:Aged; D044466:Asian People; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D020521:Stroke / Q000097:blood* / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*
chemical_list: D005343:Fibrinolytic Agents; D014527:Uric Acid; D010959:Tissue Plasminogen Activator
keywords: Acute ischemic stroke; neuroprotective; serum uric acid; thrombolysis