title: Association of serum uric acid and cardioembolic stroke in patients with acute ischemic stroke.
abstract: BACKGROUND
  Although high uric acid levels have been reported to be a risk factor for cardiovascular disease and stroke, the relationship between serum uric acid (SUA) levels and cardioembolic stroke (CES) has not been fully elucidated. In this study, we sought to investigate the relationship between the risk of CES and SUA levels. We hypothesized that SUA concentrations are associated with CES.
  
  
  METHODS
  We retrospectively analyzed 2350 patients with acute ischemic stroke who were admitted to the Seoul National University Hospital between 2002 and 2010. The participants were stratified into five groups according to SUA levels obtained within 24h after stroke onset. The association between SUA levels and CES was evaluated using multivariable logistic regression models.
  
  
  RESULTS
  Of the 2350 patients, 412 (27.7%) were classified with CES, and 1077 (72.3%) were classified with non-CES, including LAA (large artery atherosclerosis) and SVO (small vessel occlusion). Among the acute stroke patients, SUA levels were higher in those with atrial fibrillation and other cardiovascular risk factors. Compared with the non-CES patients, the CES patients were more likely to fall in the highest quintile of SUA level. Multivariate analysis revealed that the patients with SUA concentrations in the highest quintile were associated with CES (OR=2.59, 95% CI: 1.35-4.97), test for trend P<0.001. Similar results were obtained for gender-based subgroups by (in men, OR=2.34, 95% CI: 1.06-5.15 and in women OR=3.41, 95% CI: 1.15-10.07), test for trend P<0.01 and P<0.001, respectively.
  
  
  CONCLUSIONS
  SUA level is associated with the risk of CES in acute ischemic stroke patients of both sexes. Further prospective clinical trials of lowering SUA to prevent CES may be worth considering.
authors: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Xiu-Li
authors: XL
authors: Yang
authors: Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
authors: Yerim
authors: Y
authors: Kim
authors: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Tae Jung
authors: TJ
authors: Kim
authors: Department of Neurology, Changwon Hospital, Gyeongsang National University, Changwon, Republic of Korea.
authors: Seunguk
authors: S
authors: Jung
authors: Department of Neurology, Korea University Guro Hospital, Seoul, Republic of Korea.
authors: Chi Kyung
authors: CK
authors: Kim
authors: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: sb0516@snu.ac.k.
authors: Seung-Hoon
authors: SH
authors: Lee
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000209:etiology; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000097:blood* / Q000150:complications; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D020521:Stroke / Q000097:blood* / Q000209:etiology; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: Cardioembolic stroke; Ischemic stroke; Uric acid