Association of Serum Uric Acid With Early Prognosis Stratified by the Stroke Subtype in Patients With Moderate to Severe Ischemic Stroke

ABSTRACT

BACKGROUND: The role of uric acid in cerebrovascular disease is controversial. Uric acid may be an independent risk factor for cerebrovascular diseases but its neuroprotective role as an antioxidant has also been suggested. We studied the effects of uric acid on the early prognosis in acute ischemic stroke. METHODS: The subjects were 721 patients with moderate-to-severe acute stroke who arrived at hospital within 48 hours from the onset of symptoms. Patients were divided into quartiles based on serum uric acid levels at admission. In-hospital stroke outcome were calculated on the National Institutes of Health Stroke Scale (NIHSS) and analyzed by multivariate logistic regression. RESULTS: Differences in NIHSS scores between baseline and discharge in the patients were not significantly related to serum uric acid levels. However, in large artery atherosclerosis group, the proportion of patients with neurological improvement and differences in NIHSS score between baseline and discharge differed between the quartile uric acid groups (p<0.01 and p=0.04, respectively). A multivariate analysis adjusting for known vascular risk factors showed that a higher uric acid level was associated with a higher probability of a good in-hospital outcome (odds ratio, 1.31 per additional 1 mg/dL; 95% confidence interval, 1.07-1.60 per additional 1 mg/dL), but only in those with large-artery atherosclerosis. CONCLUSIONS: Uric acid level is independently correlated with the neurological improvement in patients with acute ischemic stroke caused by large-artery atherosclerosis.