Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec 21;11(12):409.
doi: 10.3390/jcdd11120409.

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

Lin Bai  1 , Gerhard Litscher  1   2   3 , Xiaoning Li  4
Affiliations
Review

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

Lin Bai et al. J Cardiovasc Dev Dis. .

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).

Keywords: meta-analysis; prevention; stroke; treatment; xanthine oxidase inhibitors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of the literature search and inclusion.
Figure 2
Figure 2
Risk of bias: risk of bias graph and risk of bias summary. All had a low risk of bias (additional explanation: Certain elements categorized as “some concerns” and “unclear risk of bias” (yellow) and “high-risk” (red) are not present in the current context or data set. As a result, they do not apply and cannot be represented in the diagram).
Figure 3
Figure 3
Results regarding primary prevention: occurrence of stroke with pooled analysis of all eligible studies.
Figure 4
Figure 4
Results regarding primary prevention: occurrence of stroke with forest plot of heterogeneity test results, with Larsen et al.’s study (2016) [26] excluded.
Figure 5
Figure 5
(A) Sensitivity analysis of all eligible studies; (B) GRADE quality evaluation of all eligible studies.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Xia Y., Liu H., Zhu R. Risk factors for stroke recurrence in young patients with first-ever ischemic stroke: A meta-analysis. World J. Clin. Cases. 2023;11:6122–6131. doi: 10.12998/wjcc.v11.i26.6122. - DOI - PMC - PubMed
    1. Chan B.P.L., Wong L.Y.H., Tan B.Y.Q., Yeo L.L.L., Venketasubramanian N. Dual antiplatelet therapy for the acute management and long-term secondary prevention of ischemic stroke and transient ischemic attack, an updated review. J. Cardiovasc. Dev. Dis. 2024;11:48. doi: 10.3390/jcdd11020048. - DOI - PMC - PubMed
    1. Kleindorfer D.O., Towfighi A., Chaturvedi S., Cockroft K.M., Gutierrez J., Lombardi-Hill D., Kamel H., Kernan W.N., Kittner S.J., Leira E.C., et al. Guideline for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline from the American Heart Association/American Stroke Association. Stroke. 2021;52:e364–e467. doi: 10.1161/STR.0000000000000375. - DOI - PubMed
    1. Li L., Scott C.A., Rothwell P.M. Association of younger vs. older ages with changes in incidence of stroke and other vascular events, 2002–2018. JAMA. 2022;328:563–574. doi: 10.1001/jama.2022.12759. - DOI - PMC - PubMed
    1. Bhatia K., Ladd L.M., Carr K.H., Di Napoli M., Saver J.L., McCullough L.D., Farahabadi M.H., Alsbrook D.L., Hinduja A., Garcia J.G.O., et al. Contemporary antiplatelet and anticoagulant therapies for secondary stroke prevention: A narrative review of current literature and guidelines. Curr. Neurol. Neurosci. Rep. 2023;23:235–262. doi: 10.1007/s11910-023-01266-2. - DOI - PubMed

LinkOut - more resources