STUDY ON PROGNOSIS OF SERUM ACID URIC IN ACUTE ISCHEMIC STROKE

2017 ◽  
pp. 119-123
Author(s):  
Dinh Toan Nguyen ◽  
Viet Hoan Tong
Keyword(s):  
Uric Acid ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Dependence ◽  
Prognostic Significance ◽  
Current Evidence ◽  
Control Group ◽  
Hospital Arrival ◽  
The Relationship

Background: Current evidence shows that uric acid is a potent antioxidant whose serum concentration increases rapidly after acute ischemic stroke (AIS). Nevertheless, the relationship between serum uric acid (SUA) levels and AIS outcome remains debatable. We aimed to describe the prognostic significance of SUA in AIS. Methods: We studied 84 patients with AIS admitted to the cardiology, Hue Central Hospital from May, 2015 to October 2016. Acid uric concentration was measured at hospital arrival, day 3 and day 7. Correlated equation was constructed to analyze the association of SUA with functional outcome as assessed by the modified Rankin scale (mRS) at 30-day follow-up. Results: Mean SUA concentration at hospital arrival was (344.86±64.84 μmol/l), day 2 (323.76±57.47 μmol/l), day 3 (308.57±42.50 μmol/l) and higher than those of control group significantly (304.93±38.29 μmol/l). SUA was correlated positively with severity assessed by NIHSS and the functional dependence (mRS >2) at 30 days. Conclusions: Our findings support the hypothesis that SUA is more a marker of the magnitude of the cerebral infarction than an independent predictor of stroke outcome. Key words: acute ischemic stroke (AIS), uric acid, prognosis

Abstract 65: Effects of Immediate Blood Pressure Reduction on Two-Year Mortality and Major Disability in Patients With Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jiang He ◽  
Yonghong Zhang ◽  
Tan Xu ◽  
Dali Wang ◽  
Chung-Shiuan Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Treatment Group ◽  
Acute Ischemic Stroke ◽  
Antihypertensive Treatment ◽  
Blood Pressure Reduction ◽  
Control Group ◽  
Antihypertensive Medications ◽  
Vascular Events

Although elevated blood pressure (BP) is very common in patients with acute ischemic stroke, the management of hypertension among them remains controversial. We tested the effect of immediate BP reduction on two-year mortality and major disability in acute ischemic stroke patients. The China Antihypertensive Trial in Acute Ischemic Stroke, a randomized, single-blind, blinded end-points trial, was conducted in 4,071 patients with ischemic stroke within 48 hours of onset and elevated systolic BP (SBP). Patients were randomly assigned to receive antihypertensive treatment (n=2,038) or to discontinue all antihypertensive medications (n=2,033) during hospitalization. Post-treatment follow-ups were conducted at 3, 12, and 24 months after hospital discharge. The primary outcome was a composite of death and major disability at the two-year follow-up visit. Mean SBP was reduced by 21.8 in the treatment group and 12.7 mm Hg in the control group within 24 hours after randomization (P<0.001). Mean SBP was 137.3 mm Hg in the treatment group and 146.5 in the control group at day 7 after randomization (P<0.001). At two-year follow-up, study outcomes were obtained in 1945 (95.4%) participants in the treatment group and 1925 (94.7%) in the control group. 78.8% of the patients in the treatment group and 72.6% in the control group reported the use of antihypertensive medications (p<0.001). SBP was 138.8 mmHg in the antihypertensive treatment group and 139.7 in the control group (p=0.02). Among patients in the antihypertensive treatment group, 24.5% (476/1945) died or had a major disability, compared with 22.1% (425/1925) in the control group (odds ratio 1.14 [95% CI 0.99 to 1.33], p=0.078). Hazard ratios for all-cause mortality (1.01 [0.81, 1.25], p=0.95), recurrent stroke (0.91 [0.73, 1.13], p=0.40), and vascular events (0.97 [0.79, 1.19], p=0.76) were not statistically significant comparing the antihypertensive treatment group to the control group. The effect of antihypertensive treatment did not differ by pre-defined subgroups. In conclusion, among patients with acute ischemic stroke, BP reduction with antihypertensive medications during hospitalization did not reduce or increase the composite outcome of death and major disability over two years.

scholarly journals Prognostic Significance of Uric Acid Serum Concentration in Patients With Acute Ischemic Stroke

Stroke ◽  
2002 ◽  
Vol 33 (4) ◽  
pp. 1048-1052 ◽  
Author(s):  
Ángel Chamorro ◽  
Victor Obach ◽  
Álvaro Cervera ◽  
Marian Revilla ◽  
Ramón Deulofeu ◽  
...  
Keyword(s):  
Uric Acid ◽  
Ischemic Stroke ◽  
Serum Concentration ◽  
Acute Ischemic Stroke ◽  
Prognostic Significance

scholarly journals Mediation of the Relationship Between Endovascular Therapy and Functional Outcome by Follow-up Infarct Volume in Patients With Acute Ischemic Stroke

2019 ◽  
Vol 76 (2) ◽  
pp. 194 ◽  
Author(s):  
Anna M. M. Boers ◽  
Ivo G. H. Jansen ◽  
Scott Brown ◽  
Hester F. Lingsma ◽  
Ludo F. M. Beenen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Endovascular Therapy ◽  
Infarct Volume ◽  
The Relationship

Abstract TP163: Metabolic Syndrome, Raised Serum Uric Acid And Poor Leptomeningeal Collateral Status In Patients With Acute Ischemic Strokes

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Bijoy K Menon ◽  
Eric E Smith ◽  
Shelagh B Coutts ◽  
Donald G Welsh ◽  
James E Faber ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Uric Acid ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Serum Uric Acid ◽  
Cerebral Artery ◽  
Clinical Information ◽  
Stroke Registry ◽  
Cross Connect

Introduction: Leptomeningeal collaterals are native (pre-existing) anastomoses that cross-connect a small number of distal-most arterioles within the crowns of the cerebral artery trees. We seek to identify potentially modifiable determinants associated with variability in leptomeningeal collateral status in patients with acute ischemic stroke. Methods: Data is from the Keimyung Stroke Registry, a prospectively collected dataset of patients with acute ischemic stroke from Daegu, South Korea. Patients with M 1 segment middle cerebral artery (MCA) +/- intracranial internal carotid artery (ICA) occlusions on baseline CT-angio from May 2004 to July 2009 were included in the study.Baseline and follow-up imaging was analyzed at the imaging core lab of the Calgary Stroke Program. Two readers blinded to all clinical information assessed leptomeningeal collaterals on baseline CT-angio by consensus using the regional leptomeningeal score (rLMC). Results: Of 206 patients[mean age66.9±11.6 years, median baseline NIHSS 14 (IQR11-20), median stroke symptom onset to CT-angio time 166 minutes (IQR 96-262)], 133 patients (64.6%) had poor collateral status at baseline (rLMC score 11-20). On univariate analyses, patients with poor collateral status at baseline were older, hypertensive, had higher blood glucose values, higher white blood cell count at baseline, higher D-dimer and serum uric acid levels (measured next day morning) and were more likely to have metabolic syndrome as per ATP III criteria. Multivariable modeling identified metabolic syndrome (OR 3.22 95% CI 1.69-6.15, p<0.001), raised serum uric acid (per 1mg/dl OR 1.35 95% CI 1.12-1.62, p<0.01) and age (per year, OR 1.03 95% CI 1-1.05, p=0.03) as independent predictors of poor leptomeningeal collateral status at baseline. Conclusion: Metabolic syndrome and hyperuricemia are modifiable determinants associated with poor leptomeningeal collateral status in patients with acute ischemic stroke. This knowledge could potentially help in focusing research on appropriate therapeutic strategies for modulating function of leptomeningeal collaterals.

Abstract 2281: Full Dose IV-tPA Followed By IA Therapy For Acute Ischemic Stroke Does Not Increase Morbidity Or Mortality

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Jeffrey M Katz ◽  
Calvin Natanzon ◽  
Avi Setton ◽  
Richard Libman
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Control Group ◽  
Bridging Therapy ◽  
Full Dose ◽  
Tissue Plasminogen ◽  
Symptomatic Intracranial Hemorrhage ◽  
The Mean ◽  
Iv Tpa

Background and Purpose: “Bridging Therapy” is well described in the literature. However the dose of bridging tissue plasminogen activator (tPA) is a matter of debate given the well-established guideline of 0.9 mg/kg as the standard intravenous dose. Previous and ongoing bridging trials use lower doses of IV-tPA (0.6 mg/kg) with a goal of maximizing safety. Our aim was to explore whether full bridging dose IV-tPA at 0.9 mg/kg can be given safely in combination with intra-arterial (IA)-tPA. Methods: Data were collected prospectively on 47 consecutive patients with acute ischemic stroke who were treated with endovascular stroke therapy (EST, that is IA-tPA +/- mechanical embolectomy (ME)). Patients who were candidates for IV-tPA, who did not clinically improve after receiving full dose IV-tPA (0.9mg/Kg), underwent EST (bridging group, n=23, 15/23 IA-tPA + ME). These patients were compared to patients treated with EST alone because they were not candidates for IV-tPA (control group, n=24, 14/24 IA-tPA + ME). Symptomatic intracranial hemorrhage (ICH) rates were recorded, as defined in the NINDS IV-tPA trial. Death rates were recorded at one month and modified Rankin score was used to measure functional outcome (6 month mean follow-up). Results: Mean age was 62 years in the bridging group and 63 years in the control group. Baseline mean National Institute of Health Stroke Scale was 20 in the bridging group and 21 in the control group (p = 0.188). The mean IA-tPA dose was 14.4 mg in the bridging group and 18.3 mg in the control group (p = 0.371). There was an 8% risk of symptomatic ICH in the control group and no symptomatic ICH in the bridging group (p = 0.155). At 30 days, mortality was 17% in the bridging group and 29% in the control group (p = 0.313). The mean follow-up modified Rankin score was 3 in the bridging group and 4 in the control group (p = 0.20). Conclusion: This non-randomized retrospective cohort study suggests that full dose IV-tPA combined with IA-tPA administered during EST is safe in patients with acute ischemic stroke. Given the possibility that full bridging dose tPA may be more effective than lower dose IV-tPA, a prospective, randomized bridging trial using full dose IV-tPA may be warranted.

Associations between Uric Acid Level and 3-Month Functional Outcome in Acute Ischemic Stroke Patients Treated with/without Edaravone

2018 ◽  
Vol 45 (3-4) ◽  
pp. 115-123
Author(s):  
Masaki Naganuma ◽  
Yuichiro Inatomi ◽  
Makoto Nakajima ◽  
Toshiro Yonehara ◽  
Yukio Ando
Keyword(s):  
Uric Acid ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Free Radical Scavenger ◽  
Radical Scavenger ◽  
Stroke Outcome ◽  
Stroke Patients ◽  
Treatment Results ◽  
Neuroprotective Effects ◽  
The Relationship

Background: Uric acid (UA), an antioxidant with neuroprotective effects, favorably affects stroke outcome. However, the effect has not been examined in patients treated with edaravone, a frequently used free radical scavenger. We investigated whether the use of edaravone affected the relationship between UA levels and outcome in acute ischemic stroke. Methods: We retrospectively evaluated 1,114 consecutive ischemic stroke patients with premorbid modified Rankin Scale (mRS) scores <2 admitted within 24 h of onset (mean, 74 years; median UA levels, 333 μmol/L). We divided the patients into 2 groups using the median UA value as a cutoff, a low UA group (≤333 μmol/L; n = 566) and a high UA group (>333 μmol/L; n = 548), and compared their clinical characteristics and favorable outcomes (mRS <2) at 90 days. We investigated the associations between UA levels and 90-day stroke outcome in patients with and without edaravone treatment. Results: The high UA group had a higher proportion of men, hypertension, atrial fibrillation, and cardioembolic stroke than the low UA group. The high UA group also had a higher proportion of patients with mRS <2 at 90 days (61.5 vs. 54.1%, p = 0.013), but the significance was diminished in multivariate analysis (OR 1.30, 95% CI 0.94–1.71). In subgroup analysis, the high UA group without edaravone exhibited a higher proportion of patients with mRS <2 at 90 days than the low UA group (OR 2.87, 95% CI 1.20–7.16). The high UA group with edaravone did not exhibit this difference. Conclusions: In acute ischemic stroke, the favorable association between high UA levels and outcome at 90 days was not evident in patients treated with edaravone.

Outcome after acute ischemic stroke treatment during Covid-19 outbreak in South-East Tuscany

2021 ◽  
Vol 21 ◽  
Author(s):  
Maurizio Acampa ◽  
Valentina Peresso ◽  
Pietro Enea Lazzerini ◽  
Carlo Domenichelli ◽  
Francesca Guideri ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Control Group ◽  
Study Group ◽  
Hospital Arrival ◽  
Stroke Treatment ◽  
Appropriate Treatment ◽  
Number Of Patients ◽  
Worse Prognosis

Background: During Covid-19 pandemic, the Italian National Healthcare Service has faced increasing pressure, especially in Northern Italy. Even in less-affected regions, such as Tuscany, the changes in the healthcare system to prevent Covid-19 spread resulted in difficulty in treating time-dependent disorders like ischemic stroke rapidly. Objective: The aim of our study was to assess the outcome after acute ischemic stroke treatments during the Covid-19 spread in comparison with a similar period of the previous year in Siena-Hospital (Hub center in the South-East Tuscany). Method: We enrolled all patients admitted to Siena-Hospital for ischemic stroke and submitted them to acute treatments (intravenous and/or mechanical thrombolysis) between February 21st and May 18th, 2020 (study group, n:38) and compared the results with ischemic strokes acutely treated in a similar period in 2019 (control group, n:39). The modified Rankin scale score was assessed at 90 days to evaluate a 3-month clinical outcome. Conclusion: During the lockdown period due to Covid-19 pandemic, patients with acute ischemic stroke had a worse prognosis. These findings suggest the need to improve the health system organization to guarantee an appropriate treatment during the pandemic, including the patients that are not affected by Covid-19. Results : In the study group, the time from symptoms onset to hospital arrival and the door-to-groin puncture time were significantly more prolonged than in the control group. In moderate-severe strokes, the 3-month mortality was significantly higher in the study group (31%vs6%; p=0.01), and the number of patients with poor functional outcomes was significantly higher in the study group (73%vs44%; p=0.03).

Abstract WP371: Role of Troponin as a Biomarker for Predicting Outcome After Ischemic Stroke: A Meta-Analysis

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adel A Alhazzani ◽  
Amit Kumar
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Prognostic Biomarker ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Elevated Serum ◽  
Cochrane Central Register ◽  
Central Register ◽  
Predicting Outcome

Background: After acute ischemic stroke, a higher level of troponin has been considered as an important biomarker for predicting mortality. The aim of the study was to quantitatively assess the prognostic significance of the effect of baseline troponin levels on mortality in patients with acute ischemic stroke using a meta-analysis approach. Design: The following electronic databases, PubMed, EMBASE, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials , TRIP Database, ClinicalTrials.govwas used for getting the relevant article from literuare. Data were extracted in standardized data collection by two independent investigators. Any disagreements were resolved by consensus. All the statistical analyses were performed in STATA software. Results: 18 studies were included in the present meta-analysis involving a total of 8723 patients. The pooled results suggested that the elevated serum troponin level was associated with in -hospital mortality (RR 2.39, 95% CI 1.37 to 3.41), at the end of last follow up mortality (RR 1.75; 95% CI 1.38 to 2.11) and for overall mortality (RR 1.82; 95% CI 1.47 to 2.17). Sensitivity analysis by removing a single study by turns indicated that there was no obvious impact of any individual study on the pooled risk estimate. No significant publication bias was observed. Conclusion: Our findings indicate that a higher level of troponinmight be an important prognostic biomarker for in hospital and follow up mortality in patients with acute ischemic stroke. The study might have clinical implications by using troponin as a prognostic biomarker for patient stratification and early intervention.

Sign in / Sign up

Export Citation Format

Share Document