Uric Acid Boosts Thrombolytic Therapy in Stroke

A new study reveals that uric acid (UA) in conjunction with intravenous thrombolytic therapy in patients suffering an acute ischemic stroke could help improve outcomes, particularly in women.

Researchers at the University of Barcelona (UB; Spain), the Sunyer Biomedical Research Institute (Barcelona, Spain), and other institutions conducted a study to investigate the efficacy of combined antioxidant treatment With UA and recombinant tissue plasminogen activator (rtPA) in acute ischemic stroke. In all, 206 women and 205 men were randomized to UA 1,000 mg or to placebo. The primary outcome was the rate of excellent outcome at 90 days using regression models adjusted for confounders associated with sex.

The results showed that excellent outcome occurred in 42% of the women treated with UA and 29% of those treated with placebo, compared to 36% of the men treated with UA and 34% treated with placebo. Treatment and sex interacted significantly with outcome, with UA therapy doubling the effect of placebo to attain an excellent outcome in women, but not in men. The interactions between treatment and serum UA levels on infarct growth were significant only in women. The study was published on July 9, 2015, in Stroke.

“This exploratory reanalysis […] highlighted the clinical value of the administration of UA in women with acute ischemic stroke who received thrombolysis within 4.5 hours of clinical onset,” concluded lead author Laura Llull, MD, of UB, and colleagues. “Given the major practical implications that could be derived in the field of acute ischemic stroke, larger confirmatory studies will be urgently required to confirm these encouraging results.”

Uric acid is a heterocyclic compound of carbon, nitrogen, oxygen, and hydrogen that forms ions and salts known as urates/acid urates. In humans UA is a result of the metabolic breakdown of purine nucleotides. High blood concentrations of UA can lead to gout, and are linked to other medical conditions, including diabetes and the formation of ammonium acid urate kidney stones. UA may also be a marker of oxidative stress, and thus has a potential therapeutic role as an antioxidant, and like other strong reducing substances (such as ascorbate), it can also act as a prooxidant.

Related Links:
University of Barcelona
Sunyer Biomedical Research Institute