Uric acid improves glucose-driven oxidative stress in human ischemic stroke

Area of Science:

• Neurology
• Metabolic Disorders
• Pharmacology

Background:

• Hyperglycemia is common in acute stroke and associated with poor outcomes.
• The role of uric acid in stroke pathophysiology and treatment is under investigation.

Purpose of the Study:

• To evaluate the efficacy of uric acid compared to placebo in improving functional outcomes in acute stroke patients with hyperglycemia.
• To assess the impact of uric acid on infarct growth in this patient subgroup.

Main Methods:

• Subgroup analysis of the URICO-ICTUS trial, a double-blind study comparing uric acid and placebo.
• Patients received alteplase within 4.5 hours of stroke onset.
• Functional outcome (modified Rankin Scale ≤ 2) and infarct growth were assessed based on admission glucose tertiles.

Main Results:

• Uric acid significantly improved excellent outcomes in patients with the highest glucose levels (OR=2.9).
• Therapy was associated with reduced infarct growth in the highest glucose tertile (p=0.04) and in patients with early recanalization.
• No significant benefits were observed in patients with lower glucose levels.

Conclusions:

• Uric acid therapy demonstrates potential benefits in acute stroke patients with hyperglycemia.
• The positive effects appear more pronounced in patients with elevated glucose levels, impacting both functional outcome and infarct size.