{"title":"The Effect of Xanthine Oxidase Inhibitors in the Prevention and Treatment of Stroke: A Systematic Review and Meta-Analysis.","authors":"Lin Bai, Gerhard Litscher, Xiaoning Li","doi":"10.3390/jcdd11120409","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Xanthine oxidase inhibitors (XOIs) may help prevent stroke. However, heterogeneity can be found in the conclusions of different studies. The relevant evidence was summarized in this systematic review and meta-analysis to further clarify the role of XOIs in the prevention and treatment of stroke, with a focus on evaluating the effects of XOIs in primary and secondary prevention of stroke, acute stroke treatment, and reduction of post-stroke complications.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) or cohort studies on the effect of XOIs in the prevention and treatment of stroke were searched in PubMed, EMBASE, and Cochrane Library from inception to 3 March 2024, along with hand searching. The analyses were carried out using Review Manager 5.4.</p><p><strong>Results: </strong>The analysis included 14 studies (115,579 patients). While XOIs did not significantly reduce the risk of stroke (RR: 0.89; 95% CI: 0.59-1.34), they improved post-stroke functional outcomes, with a reduction in the modified Rankin scale scores (mean difference: -0.6; 95% CI: -0.8 to -0.4), decreased intercellular adhesion molecule-1 levels (mean difference: -15.2 ng/mL; 95% CI: -22.3 to -8.1), improved augmentation index (AIx) by 4.2% (95% CI: 2.5-5.9%), reduced central blood pressure (mean reduction: 4.8 mmHg; 95% CI: 2.6-6.9), and delayed carotid intima-media thickness progression (mean difference: -0.05 mm/year; 95% CI: -0.08 to -0.02).</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"11 12","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679907/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular Development and Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/jcdd11120409","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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Abstract
Background: Xanthine oxidase inhibitors (XOIs) may help prevent stroke. However, heterogeneity can be found in the conclusions of different studies. The relevant evidence was summarized in this systematic review and meta-analysis to further clarify the role of XOIs in the prevention and treatment of stroke, with a focus on evaluating the effects of XOIs in primary and secondary prevention of stroke, acute stroke treatment, and reduction of post-stroke complications.
Methods: Randomized controlled trials (RCTs) or cohort studies on the effect of XOIs in the prevention and treatment of stroke were searched in PubMed, EMBASE, and Cochrane Library from inception to 3 March 2024, along with hand searching. The analyses were carried out using Review Manager 5.4.
Results: The analysis included 14 studies (115,579 patients). While XOIs did not significantly reduce the risk of stroke (RR: 0.89; 95% CI: 0.59-1.34), they improved post-stroke functional outcomes, with a reduction in the modified Rankin scale scores (mean difference: -0.6; 95% CI: -0.8 to -0.4), decreased intercellular adhesion molecule-1 levels (mean difference: -15.2 ng/mL; 95% CI: -22.3 to -8.1), improved augmentation index (AIx) by 4.2% (95% CI: 2.5-5.9%), reduced central blood pressure (mean reduction: 4.8 mmHg; 95% CI: 2.6-6.9), and delayed carotid intima-media thickness progression (mean difference: -0.05 mm/year; 95% CI: -0.08 to -0.02).
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