Study of Serum Uric Acid Level as an Independent Risk Factor in Acute Ischemic Stroke

Author(s): Chandrashekhar K.1 , Mohammed Anwar Hussain2 , Ishwar S. Hasabi3 , Suryakanth4 , Chethan K. Ganteppanavar5

BACKGROUND Stroke entails a high socioeconomic burden due to increased mortality and morbidity. The role of serum uric acid (SUA) level as an independent risk factor for stroke has been questioned for many years. Evidence from epidemiological studies suggest that elevated SUA levels may be associated with an increased risk of stroke and cardiovascular events. METHODS 113 patients of first ever lifetime acute ischemic stroke admitted in Karnataka Institute of Medical Sciences, Hubli Hospital, were included. Blood samples were taken and CT scans were done within 24 hrs. of onset of stroke. Serum uric acid levels were analysed in patients and were compared with risk factors like hypertension, diabetes, adverse lipid profile, smoking and alcoholism. RESULTS The age of subjects ranged from 25 years to 90 years. Mean age was 59.2 ± 14.5 yrs. Most of the patients were aged ≥ 65 yrs. (46%). 76 were males (67.3%) and 37 females (32.7%). Male to female ratio in this study was 2.05:1. 37.2% patients were diabetic. 56.6% patients were hypertensive. 46.9% patients had elevated SUA levels. Mean SUA levels in 113 acute ischemic stroke patients was 6.5 ± 1.4. Mean SUA levels among males 6.4 ± 1.5 and among females it was 6.6 ± 1.5. (difference not statistically significant). Mean SUA level was higher (6.83 ± 1.5 mg/dl) among hypertensives (6.83 ± 1.5) compared to non-hypertensive patients (6.21 ± 1.4) and the difference was statistically significant. Mean SUA was higher among diabetics (6.9 ± 1.5) as compared to non-diabetics (6.2 ± 1.4) and the difference was statistically significant. CONCLUSIONS SUA levels were significantly elevated in ischemic stroke patients within 24 hours after symptom onset. SUA levels were significantly higher among hypertensive patients as compared to normotensive patients. SUA levels were significantly higher among diabetic patients as compared to non-diabetic patients. Due to the high prevalence of high SUA in patients with acute stroke, and its accompanying increase in hypertension and diabetes mellitus, it can be considered as a risk factor for acute stroke.