title: Highly Prevalent Hyperuricaemia is Associated with Adverse Clinical Outcomes Among Ghanaian Stroke Patients: An Observational Prospective Study.
abstract: BACKGROUND
  Although a direct causal relationship between hyperuricaemia and stroke continues to be debated, strong associations between serum uric acid (SUA) and cerebrovascular disease exist. Very few studies have been conducted to evaluate the frequency and association between this potentially modifiable biomarker of vascular risk and stroke in sub-Saharan Africa. Therefore the aim of this study was to examine the association between hyperuricaemia and the traditional risk factors and the outcomes of stroke in Ghanaian patients.
  
  
  METHODS
  In this prospective observational study, 147 patients presenting with stroke at a tertiary referral centre in Ghana were consecutively recruited. Patients were screened for vascular risk factors and SUA concentrations measured after an overnight fast. Associations between hyperuricaemia and stroke outcomes were analysed using Kaplan-Meier and Cox proportional hazards regression analysis.
  
  
  RESULTS
  The frequency of hyperuricaemia among Ghanaian stroke patients was 46.3%. Non-significant associations were observed between hyperuricaemia and the traditional risk factors of stroke. SUA concentration was positively correlated with stroke severity and associated with early mortality after an acute stroke with unadjusted hazards ratio of 2.3 (1.4 - 4.2, p=0.001). A potent and independent dose-response association between increasing SUA concentration and hazard of mortality was found on Cox proportional hazards regression, aHR (95% CI) of 1.65 (1.14-2.39), p=0.009 for each 100µmol/l increase in SUA.
  
  
  CONCLUSIONS
  Hyperuricaemia is highly frequent and associated with adverse functional outcomes among Ghanaian stroke patients. Further studies are warranted to determine whether reducing SUA levels after a stroke would be beneficial within our setting.
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ; Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: F S
authors.initials: FS
authors.lastname: Sarfo
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ; Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: J
authors.initials: J
authors.lastname: Akassi
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: N K B
authors.initials: NK
authors.lastname: Antwi
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: V
authors.initials: V
authors.lastname: Obese
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: S
authors.initials: S
authors.lastname: Adamu
authors.affiliation: Korle-Bu Teaching Hospital, Accra, Ghana.
authors.forename: A
authors.initials: A
authors.lastname: Akpalu
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ; Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: G
authors.initials: G
authors.lastname: Bedu-Addo
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D033461:Hyperuricemia / Q000453:epidemiology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality*; D062606:Tertiary Care Centers; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: Ghana; Hyperuricaemia; mortality; stroke