Is uric acid protective or deleterious in acute ischemic stroke? A prospective cohort study

• Published in: Atherosclerosis Vol. 209; no. 1; pp. 215 - 219
• Main Authors: Seet, Raymond C.S, Kasiman, Katherine, Gruber, Jan, Tang, Soon-Yew, Wong, Meng-Cheong, Chang, Hui-Meng, Chan, Yiong-Huak, Halliwell, Barry, Chen, Christopher P
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.03.2010; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Asian Continental Ancestry Group; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Female; Humans; Infarction; Male; Medical sciences; Middle Aged; Neurology; Prognosis; Prospective Studies; Singapore; Stroke; Stroke - blood; Stroke - diagnosis; Uric acid; Uric Acid - blood; Vascular diseases and vascular malformations of the nervous system; Singapore; Stroke; Infarction; Prognosis; Uric acid; Cerebral infarction; Nervous system diseases; Infarct; Cardiovascular disease; Cerebral disorder; Vascular disease; Prevention; Cohort study; Central nervous system disease; Atherosclerosis; Brain ischemia; Cerebrovascular disease
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2009.08.012

Abstract Contrasting observations have been made between serum urate and ischemic stroke outcomes in studies involving Caucasian populations. To assess the hypothesis that urate is associated with stroke outcomes, a prospective follow-up study was performed in a cohort of Asian patients with ischemic stroke. Patients diagnosed with transient ischemic attack, first or recurrent ischemic stroke were included in this study. Serum urate, measured using high-performance liquid chromatography, was correlated with 12-month functional and vascular stroke outcomes. Poor functional outcome was defined as a modified Rankin scale exceeding 2 and vascular outcome was defined as a composite of recurrent stroke, myocardial infarction or vascular death during the study period. A total of 503 patients of mean age 63 (SD 12) years were included. A U-shaped relationship between urate quartiles and poor functional outcomes was demonstrated. More patients with low (<280 μM) and high (>410 μM) urate levels had poor functional outcomes (36% and 27% respectively), compared to those with urate levels between 340 and 410 μM (14%). No significant relationship was observed between urate and vascular outcomes. Depending on its level, serum urate may exhibit protective and deleterious effects on stroke outcomes.