Abstract 3287: Effects Of Serum Uric Acid On Outcomes Following Acute Stroke

Abstract

Objective: Emerging data show that increased serum uric acid (UA) concentration is an independent risk factor for cardiovascular disease, chronic kidney disease, and stroke. Clinicians and researchers do not regularly monitor serum UA following stroke; therefore, we examined whether serum UA was correlated with neurological outcome after stroke. Patients and Methods: Consecutive acute stroke patients (n=1688; 348 hemorrhagic stroke, 1239 ischemic stroke, 101 TIA; median age 70; 1080 males) participated in this study and provided written informed consent to participate. All patients were admitted within 7 days of stroke onset to a regional brain attack center in Japan between January 2005 and December 2010. Patients who showed prehospital modified Rankin scale (mRS) scores of 0-1 were asked about daily lifestyle using the mRS at 3 months after stroke. We measured serum UA, estimated glomerular filtration rate (eGFR) calculated from serum creatinine, and recorded the age and sex of each patient. Patients whose mRS score at 3 months after stroke onset was 2-5 or who died after the stroke were classified into the “poor-outcome” group; patients with a mRS score of 0-1 were classified into the “fair-outcome” group. Logistic regression analysis was used to calculate the odds ratio of poor outcomes; the 95% CI for association between eGFR or UA and poor outcome were examined after adjusting for age greater than 75 years; sex; past history of stroke and/or TIA; current smoking and/or drinking status; hypertension; hypercholesterolemia; and diabetes mellitus. Results: The poor-outcome group included 704 patients, and had a higher proportion of females, patients with hypertension and/or hypercholesterolemia, and age over 75 years than did the fair-outcome group (984 patients). No intergroup differences were observed between the poor outcome and fair outcome groups for eGFR (69.4 ± 22.8 vs. 71.0 ± 19.4 ml/min, respectively, p=0.127) or UA (5.49 ± 1.70 vs. 5.44 ± 1.50 mg/dl, p=0.488). However, after adjusting for the above factors, an increase in eGFR of 1 ml/min was not correlated with poor neurological outcomes (odds ratio=1.004, 95% CI: 0.998-1.009), but an increase in serum UA by 1 mg/dl was positively correlated with poor outcome (odds ratio = 1.088, 95% CI: 1.007-1.176, p=0.033). Conclusion: After adjusting for confounders and variables, low serum UA upon hospital admission was positively correlated with fair neurological outcome 3 months after acute stroke, indicating that UA may contribute slightly to functional impairment associated with stroke.