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Serum Uric Acid Level and Outcome of Patients With Ischemic Stroke

A Systematic Review and Meta-Analysis

Lei, Zhihao MD*,†; Cai, Jingjing MD*; Hong, Hua MD, PhD; Wang, Yidong MD, PhD†,§,∥

doi: 10.1097/NRL.0000000000000234
Original Articles
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Background: The issue of whether serum uric acid (SUA) is associated with the outcome of acute ischemic stroke is controversial. This study aimed to evaluate the correlation between the SUA level and outcome of patients with ischemic stroke by performing a meta-analysis.

Materials and Methods: Studies were included by a systematic search of several databases through December 01, 2018, followed by reviewing reference lists of obtained articles. Studies that included odds ratios (ORs) for ischemic stroke outcome per unit SUA level with 95% confidence intervals (95% CIs) were eligible for the meta-analysis. A random-effects model was used to calculate the pooled risk estimate. Publication bias was detected by Begg’s test.

Results: Fifteen studies with a total of 12,739 cases of stroke were included. Overall, higher SUA levels were associated with a significantly better outcome of ischemic stroke (OR, 1.13; 95% CI, 1.07-1.18; P<0.00001). For patients receiving thrombolytic therapy, a subgroup meta-analysis showed a positive association between SUA level and patient outcome (OR, 1.26; 95% CI, 1.14-1.40; P<0.00001). In addition, the pooled estimate of patients with a modified Rankin Scale score ≤2 at 90 days also showed a positive association (OR, 1.07; 95% CI, 1.01-1.133; P<0.00001). Furthermore, we found that the average SUA level in patients with a good outcome was higher than in those with a poor outcome (mean difference, 0.24 µmol/L; 95% CI, 0.16-0.32; P<0.00001).

Conclusions: This meta-analysis suggested that there was a significant positive association between SUA level and the outcome of ischemic stroke.

*Department of Neurology, Shenzhen Second People's Hospital, Shenzhen

Department of Neurology, Sun Yat-sen Memorial Hospital

Department of Neurology, The First Affiliated Hospital

§Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine

Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes, Sun Yat-sen University, Guangzhou, Guangdong Province, China

Z.L. and J.C. contributed equally.

Z.L. and J.C.: conceived and designed the study. Z.L., J.C., and H.H.: collected the data. Z.L., J.C., and Y.W.: analyzed the data. Z.L.: drafted the manuscript.

Supported by the National Natural Science Foundation of China (No. 81171103) and Guangzhou Science and Technology Program (2014Y2-00502).

The authors declare no conflict of interest.

Correspondence to: Yidong Wang, MD, PhD, Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Guangzhou 510120, Guangdong Province, China. E-mail: wydys@126.com.

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