Cardiovascular Risk Assessment After One-Yearacute Ischemic Stroke Based on Uric Acid Levels and Renal Dysfunction. A Clinical Study.

BACKGROUND: The role of serum uric acid (SUA) after stroke is controversial and can be influenced byrenal disease. AIM: to analyse the role of SUA in the acute phase of stroke based on the presence/absence of kidney disease and cardiovascular outcome. METHODS: Retrospective cohort of a stroke registry followed-up for one year. The sample was divided according to the presence of renal disease defined by haematocrit, urea and gender (HUGE) formula, along with a SUA cut-off point obtained byreceiver operating characteristic curves based on SUA levels and on the primary end-point occurrence. RESULTS: 500 patients (268, 53.6% males) were analysed. Renal disease was present in 14.8% patients. The SUA cut-off for patients with renal disease was 404.46 mumol/L and 344.98 mumol/L for the remainder. Patients with higher SUA levels had decreased neurological disabilities (P = 0.04) and higher comorbidity (P = 0.00). Over a period of 42.3 (19) weeks,a primary end-point occurred in 17.4% patients. In the adjusted Cox model,SUA was associated with the primary end-point (HR 1.45, 95%CI 1.17-1.81, p = 0.01). Separated by the presence/absence of renal disease, SUA levels were associated with the primary endpoint for patients with renal disease (HR 1.29, 95%CI 1.06-1.58, p = 0.01)and for all other patients (HR 1.42, 95%CI 1.2-1.7, p = 0.00). CONCLUSIONS: We observed a relationship between SUA levels and a negative cardiovascular outcome after ischaemic stroke both in patients with and without renal disease, with the worst outcomes occurring in patients with renal insufficiency.