The Effect of Xanthine Oxidase Inhibitors in the Prevention and Treatment of Stroke: A Systematic Review and Meta-Analysis.

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Development and Disease Pub Date : 2024-12-21 DOI:10.3390/jcdd11120409

Lin Bai, Gerhard Litscher, Xiaoning Li

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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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黄嘌呤氧化酶抑制剂在脑卒中预防和治疗中的作用：一项系统综述和荟萃分析。

背景：黄嘌呤氧化酶抑制剂（XOIs）可能有助于预防中风。然而，不同研究的结论存在异质性。本文通过系统综述和荟萃分析，总结相关证据，进一步明确XOIs在脑卒中预防和治疗中的作用，重点评价XOIs在脑卒中一级和二级预防、急性脑卒中治疗和减少脑卒中后并发症方面的作用。方法：检索PubMed、EMBASE和Cochrane图书馆自成立至2024年3月3日期间关于XOIs预防和治疗脑卒中效果的随机对照试验（rct）或队列研究，并进行人工检索。使用Review Manager 5.4进行分析。结果：纳入14项研究（115,579例患者）。而XOIs没有显著降低卒中风险(RR: 0.89；95% CI: 0.59-1.34)，它们改善了卒中后功能结局，降低了改良Rankin量表评分(平均差异：-0.6；95% CI: -0.8 ~ -0.4)，细胞间粘附分子-1水平降低(平均差异：-15.2 ng/mL；95% CI: -22.3至-8.1)，增强指数（AIx）提高4.2% (95% CI: 2.5-5.9%)，降低中心血压(平均降低：4.8 mmHg；95% CI: 2.6-6.9)，颈动脉内膜-中膜厚度进展延迟(平均差异：-0.05 mm/年；95% CI: -0.08 ~ -0.02)。

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