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

<b><i>Background:</i></b> 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. <b><i>Methods:</i></b> We retrospectively evaluated 1,114 consecutive ischemic stroke patients with premorbid modified Rankin Scale (mRS) scores &#x3c;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; <i>n</i> = 566) and a high UA group (&#x3e;333 μmol/L; <i>n</i> = 548), and compared their clinical characteristics and favorable outcomes (mRS &#x3c;2) at 90 days. We investigated the associations between UA levels and 90-day stroke outcome in patients with and without edaravone treatment. <b><i>Results:</i></b> 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 &#x3c;2 at 90 days (61.5 vs. 54.1%, <i>p</i> = 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 &#x3c;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. <b><i>Conclusions:</i></b> In acute ischemic stroke, the favorable association between high UA levels and outcome at 90 days was not evident in patients treated with edaravone.