Prognostic Significance of Serum Uric Acid and Mortality Outcomes in Patients with Acute Cerebrovascular Ischemic Stroke

摘要

Cerebrovascular ischemic stroke (CVIS) is the leading cause of death worldwide after cardiovascular disease (CVD) and cancer. Raised serum uric acid (SUA) is the major risk factor for CVIS. However, the relationship between SUA and CVIS is not clear, whether the association is casual or circumstantial. In this case control study, we sought to investigate the prognostic role of SUA in acute CVIS patients and its association with stroke outcomes. Twenty five CVIS patients (16 males & 9 females) and same number of age matched control subjects were recruited for this study. CVIS male patients showed significantly (P<0.001) higher SUA levels than CVIS female patients. A negative correlation was observed between age and SUA levels. We also found a significant inverse correlation of SUA levels with HDL-c, and a positive correlation with triglycerides (r = -0.247; P = 0.001 for HDL-c and r = 0.286, P = 0.001 for triglycerides). Mean SUA levels in CVIS patients were higher on admission, and its association with mortality remained after the adjustment for covariates (Hazard Ratio (HR) = 1.21, 95% confidence interval (CI) 1.07-1.45; P = 0.001). In some of the patients (5 males & 2 females) whose SUA levels were high on admission, consistently raised further during ICU stay were died. These patients belonged to National Institute of Health Stroke (NIHS) Score -9 or quartile 3/4 as per Kaplan–Meier analysis. In conclusion, present results suggest that SUA levels were correlated with all-cause death in CVIS patients. The strong association of SUA levels with CVIS males, compared with the much lesser degree in females regardless of metabolic risk variables, highlights the necessity of intervention studies to determine whether SUA is a potential therapeutic target or mear a prognostic marker of mortality risk.