Mol Neurobiol DOI 10.1007/s12035-015-9134-1
Serum Uric Acid Levels and Outcomes After Acute Ischemic Stroke Zhongchao Wang & Yanlin Lin & Yuxiu Liu & Ying Chen & Bin Wang & Changgui Li & Shengli Yan & Yangang Wang & Wenjuan Zhao
Received: 3 November 2014 / Accepted: 22 February 2015 # Springer Science+Business Media New York 2015
Abstract Previous studies assessing the association between serum uric acid levels and neurological outcome after acute ischemic stroke reported conflicting results. A systematic review and meta-analysis were conducted to assess the impact of serum uric acid levels on outcome after acute ischemic stroke. Pubmed, Embase, Web of Science, and Google scholar were searched through September 26, 2014 to identify eligible published or unpublished studies on the association between serum uric acid levels and outcome after acute ischemic stroke. Hazard ratio (HR) for poor outcome or mean differences of serum uric acid levels with 95 % confidence intervals (95 % CIs) were pooled using meta-analysis. The primary outcome was occurrence of poor outcomes, while the secondary outcome was the mean differences of serum uric acid levels in patients with good or poor outcomes. Ten eligible studies with a total of 8131 acute ischemic stroke patients were included into the meta-analysis. Compared with low serum uric acid level, high serum uric acid level was associated better outcome after acute ischemic stroke (HR=0.77, 95 % CI 0.68–0.88, P=0.0001). Sensitivity analysis further identified the prognostic role of serum uric acid levels on outcome after acute ischemic stroke. Patients with good outcomes had a higher serum uric acid level compared with those with poor outcome (mean difference=30.61 μmol/L, 95 % CI
Zhongchao Wang, Yuxiu Liu and Ying Chen contributed equally to this work. Z. Wang : Y. Lin : Y. Chen : B. Wang : S. Yan : Y. Wang (*) : W. Zhao (*) Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao 266003, China e-mail: [email protected] e-mail: [email protected] Y. Liu : C. Li Shandong Provincial Key Laboratory of Metabolic Disease, Affiliated Hospital of Qingdao University, Qingdao 266003, China
20.13–41.08, P10 or death at hospital discharge as poor outcome Poor outcomes (mRS>2, all-cause death, vascular events, stroke recurrent) at 14 days, 90 days, and 1 year after stroke Excellent outcome was defined as a 3-month mRS score of 0 in patients with a baseline NIHSS score 4.2 vs. ≤4.1 mg/dL): HR (95 % CI) 1.63 (0.78–3.42) for good outcome
Per 1 mg/dL increment: HR (95 % CI) 1.23 (1.03–1.49) for good outcome; uric acid differences between groups Per 100 μmol/L increment: HR (95 % CI) 1.14 (0.74–1.78) for good outcome Per 1 mg/dL increment: HR (95 % CI) 0.55 (0.35–0.86) for poor outcome Per 100 μmol/L increment for poor outcome at 12 months: HR (95 % CI): 0.71 (0.61–0.81)
Decrease of uric acid (340 mmol/L): HR (95 % CI) 2.41 (0.87–6.52) for poor outcome
Uric acid differences between groups; Increment of uric acid (>336 vs.
Serum Uric Acid Levels and Outcomes After Acute Ischemic Stroke Zhongchao Wang & Yanlin Lin & Yuxiu Liu & Ying Chen & Bin Wang & Changgui Li & Shengli Yan & Yangang Wang & Wenjuan Zhao
Received: 3 November 2014 / Accepted: 22 February 2015 # Springer Science+Business Media New York 2015
Abstract Previous studies assessing the association between serum uric acid levels and neurological outcome after acute ischemic stroke reported conflicting results. A systematic review and meta-analysis were conducted to assess the impact of serum uric acid levels on outcome after acute ischemic stroke. Pubmed, Embase, Web of Science, and Google scholar were searched through September 26, 2014 to identify eligible published or unpublished studies on the association between serum uric acid levels and outcome after acute ischemic stroke. Hazard ratio (HR) for poor outcome or mean differences of serum uric acid levels with 95 % confidence intervals (95 % CIs) were pooled using meta-analysis. The primary outcome was occurrence of poor outcomes, while the secondary outcome was the mean differences of serum uric acid levels in patients with good or poor outcomes. Ten eligible studies with a total of 8131 acute ischemic stroke patients were included into the meta-analysis. Compared with low serum uric acid level, high serum uric acid level was associated better outcome after acute ischemic stroke (HR=0.77, 95 % CI 0.68–0.88, P=0.0001). Sensitivity analysis further identified the prognostic role of serum uric acid levels on outcome after acute ischemic stroke. Patients with good outcomes had a higher serum uric acid level compared with those with poor outcome (mean difference=30.61 μmol/L, 95 % CI
Zhongchao Wang, Yuxiu Liu and Ying Chen contributed equally to this work. Z. Wang : Y. Lin : Y. Chen : B. Wang : S. Yan : Y. Wang (*) : W. Zhao (*) Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao 266003, China e-mail: [email protected] e-mail: [email protected] Y. Liu : C. Li Shandong Provincial Key Laboratory of Metabolic Disease, Affiliated Hospital of Qingdao University, Qingdao 266003, China
20.13–41.08, P10 or death at hospital discharge as poor outcome Poor outcomes (mRS>2, all-cause death, vascular events, stroke recurrent) at 14 days, 90 days, and 1 year after stroke Excellent outcome was defined as a 3-month mRS score of 0 in patients with a baseline NIHSS score 4.2 vs. ≤4.1 mg/dL): HR (95 % CI) 1.63 (0.78–3.42) for good outcome
Per 1 mg/dL increment: HR (95 % CI) 1.23 (1.03–1.49) for good outcome; uric acid differences between groups Per 100 μmol/L increment: HR (95 % CI) 1.14 (0.74–1.78) for good outcome Per 1 mg/dL increment: HR (95 % CI) 0.55 (0.35–0.86) for poor outcome Per 100 μmol/L increment for poor outcome at 12 months: HR (95 % CI): 0.71 (0.61–0.81)
Decrease of uric acid (340 mmol/L): HR (95 % CI) 2.41 (0.87–6.52) for poor outcome
Uric acid differences between groups; Increment of uric acid (>336 vs.
