Uric Acid Therapy Improves Clinical Outcome in Women With Acute Ischemic Stroke
Uric Acid Therapy Improves Clinical Outcome in Women With Acute Ischemic Stroke
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DOI：
10.1161/strokeaha.115.009960
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发表时间：
2015-08-01
期刊：
影响因子：
8.3
通讯作者：
Chamorro, Angel
中科院分区：
文献类型：
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作者：
Llull, Laura;Laredo, Carlos;Chamorro, Angel
背景和目的：目前尚不清楚男性和女性急性缺血性卒中患者对抗氧化剂联合溶栓治疗的反应是否相似。在这里，我们调查了独立的影响，性别对尿酸（UA）治疗的急性中风患者用阿替普酶治疗。方法，在联合治疗与尿酸和rtPA在急性缺血性中风（URICO-ICTUS）试验的疗效研究，206名女性和205名男性随机UA 1000毫克或安慰剂。在这项试验的再分析中，主要结局是使用回归模型调整与性别相关的混杂因素后，女性和男性在90天时的优良结局率（改良兰金量表，0-1，或2，如果发病前评分为2）。UA水平的相互作用，通过治疗对梗死growthinselfpatients.Results-Excellent结果发生在47的111（42%）女性治疗UA，28的95（29%）与安慰剂治疗，并在36的100（36%）男性治疗UA和38的105（34%）与安慰剂治疗。治疗和性别与良好结局显著交互作用（P=0.045）。因此，UA治疗使安慰剂的效果加倍，在女性中获得了良好的结局（比值比[95%置信区间]，2.088 [1.050-4.150]; P=0.036），但在男性中没有（比值比[95%置信区间]，0.999 [0.516-1.934]; P=0.997）。治疗与血清UA水平之间的交互作用（P
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