title: Is uric acid protective or deleterious in acute ischemic stroke? A prospective cohort study.
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 (<280microM) and high (>410microM) urate levels had poor functional outcomes (36% and 27% respectively), compared to those with urate levels between 340 and 410microM (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.
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. raymond_seet@nus.edu.sg
authors.forename: Raymond C S
authors.initials: RC
authors.lastname: Seet
authors.forename: Katherine
authors.initials: K
authors.lastname: Kasiman
authors.forename: Jan
authors.initials: J
authors.lastname: Gruber
authors.forename: Soon-Yew
authors.initials: SY
authors.lastname: Tang
authors.forename: Meng-Cheong
authors.initials: MC
authors.lastname: Wong
authors.forename: Hui-Meng
authors.initials: HM
authors.lastname: Chang
authors.forename: Yiong-Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Barry
authors.initials: B
authors.lastname: Halliwell
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012846:Singapore; D020521:Stroke / Q000097:blood* / Q000175:diagnosis*; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid