The prognostic value of serum uric acid (UA) in acute ischemic stroke is controversial. The aim of this study is to further analyse the relation between UA and outcome after acute ischemic stroke.
We analysed UA levels in blood samples collected within 6 h of stroke onset from patients included in the placebo arm of the US and Canadian Lubeluzole Ischemic Stroke Study (LUB-INT-9). We compared mean serum UA levels in patients with and without early neurological improvement (≥4 versus <4 points improvement on NIHSS after 5 days) and in patients with good functional and poor functional outcome (mRS 0–2 versus mRS 3–6). Multivariable logistic regression analyses were performed to adjust for possible confounders.
UA levels of 226 patients were available for analysis. Mean serum UA levels were not significantly higher in patients with than without early neurological improvement (0.33 mmol/L versus 0.30 mmol/L, p=0.070). The difference between patients with good and patients with poor functional outcome was borderline statistically significant (0.34 mmol/L versus 0.31 mmol/L, p=0.050). After adjustment for confounders, higher serum UA levels were neither associated with early neurological improvement OR (1.30, 95% CI 0.98–1.73, p=0.069), nor with a good functional outcome (OR 1.09, 95% CI 0.72–1.65, p=0.690).
We found no association between admission serum UA levels and both short- and long-term outcome in acute ischemic stroke.
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- The role of uric acid in stroke: the issue remains unresolved.Neurologist. Jul 2008; 14: 238-242
- Hyperuricemia and risk of stroke: a systematic review and meta-analysis.Arthritis Rheum. Jul 15 2009; 61: 885-892
- Towards the physiological function of uric acid.Free Radic Biol Med. Jun 1993; 14: 615-631
- Uric acid: an important antioxidant in acute ischaemic stroke.QJM. Oct 2002; 95: 691-693
- Potential markers of oxidative stress in stroke.Free Radic Biol Med. Oct 1 2005; 39: 841-852
- Systemic uric acid administration increases serum antioxidant capacity in healthy volunteers.J Cardiovasc Pharmacol. Sep 2001; 38: 365-371
- Uric acid reduces brain damage and improves the benefits of rt-PA in a rat model of thromboembolic stroke.J Cereb Blood Flow Metab. Jan 2007; 27: 14-20
- Uric acid protects neurons against excitotoxic and metabolic insults in cell culture, and against focal ischemic brain injury in vivo.J Neurosci Res. Sep 1 1998; 53: 613-625
- Prognostic significance of uric acid serum concentration in patients with acute ischemic stroke.Stroke. Apr 2002; 33: 1048-1052
- Uric acid levels are relevant in patients with stroke treated with thrombolysis.Stroke. Jan 2011; 42: S28-S32
- Serum uri acid: neuroprotection in thrombolysis. The Bergen NORSTROKE study.BMC Neurol. Sep 25 2011; 11: 114
- Baseline serum urate and 90-day functional outcomes following acute ischemic stroke.Cerebrovasc Dis. 2009; 28: 202-203
- Serum uric acid as an independent predictor of early death after acute stroke.Circ J. Jul 2007; 71: 1120-1127
- Elevated serum urate concentration independently predicts poor outcome following stroke in patients with diabetes.Diabetes Metab Res Rev. Jan-Feb 2006; 22: 79-82
- Is uric acid protective or deleterious in acute ischemic stroke? A prospective cohort study.Atherosclerosis. Mar 2010; 209: 215-219
- Serum urate as an independent predictor of poor outcome and future vascular events after acute stroke.Stroke. Aug 2003; 34: 1951-1956
- Release of platelet constituents by monosodium urate crystals.J Clin Invest. Nov 1977; 60: 999-1007
- Lubeluzole treatment of acute ischemic stroke. The US and Canadian Lubeluzole Ischemic Stroke Study Group.Stroke. Dec 1997; 28: 2338-2346
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke. Jan 1993; 24: 35-41
- The stroke-thrombolytic predictive instrument: a predictive instrument for intravenous thrombolysis in acute ischemic stroke.Stroke. Dec 2006; 37: 2957-2962
- Low plasma antioxidant activity is associated with high lesion volume and neurological impairment in stroke.Stroke. Jan 2000; 31: 33-39
- The URICO-ICTUS study, a phase 3 study of combined treatment with uric acid and rtPA administered intravenously in acute ischaemic stroke patients within the first 4.5 h of onset of symptoms.Int J Stroke. Aug 2010; 5: 325-328
Published online: May 28, 2012
Accepted: May 4, 2012
Received in revised form: May 1, 2012
Received: March 15, 2012
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.