Department of Epidemiology and Biostatistics, School of Public Health Jilin University Changchun China.
Stroke Center & Clinical Trial and Research Center for Stroke, Department of Neurology The First Hospital of Jilin University Changchun China.
J Am Heart Assoc. 2024 Apr 2;13(7):e033407. doi: 10.1161/JAHA.123.033407. Epub 2024 Mar 27.
The study aimed to investigate the relationship between uric acid (UA) levels and functional outcomes at 3 months in patients with acute ischemic stroke (AIS) who underwent intravenous thrombolysis (IVT).
This prospective cohort study included 1001 consecutive patients with AIS who underwent IVT. The correlation between UA levels and post-IVT AIS outcomes was examined. Any nonlinear relationship was assessed using a restricted cubic spline function. The nonlinear value for the association of UA levels with favorable (modified Rankin Scale [mRS] score ≤2) and excellent (mRS score ≤1) outcomes at 3 months post-IVT were <0.001 and 0.001, respectively. However, for patients with and without hyperuricemia, no evident nonlinear relationship was observed between UA levels and favorable 3-month post-IVT outcomes, with nonlinear values of 0.299 and 0.207, respectively. The corresponding interaction analysis yielded a value of 0.001, indicating significant heterogeneity. Similar results were obtained for excellent outcomes at 3 months post-IVT. In the hyperuricemia group, increased UA levels by 50 μmol/L reduced the odds of a favorable 3-month post-AIS outcome (odds ratio [OR], 0.75 [95% CI, 0.57-0.97]). Conversely, in the nonhyperuricemia group, a similar UA increase was linked to higher favorable outcome odds (OR, 1.31 [95% CI, 1.15-1.50]).
An inverted U-shaped nonlinear relationship was observed between UA levels and favorable and excellent outcomes at 3 months in patients with AIS who underwent IVT. Higher UA levels predict favorable outcomes in patients without hyperuricemia but unfavorable outcomes in those with hyperuricemia.
本研究旨在探讨接受静脉溶栓（IVT）治疗的急性缺血性脑卒中（AIS）患者血尿酸（UA）水平与 3 个月时功能结局的关系。
这是一项前瞻性队列研究，纳入了 1001 例接受 IVT 的 AIS 连续患者。研究考察了 UA 水平与 post-IVT AIS 结局之间的相关性。采用限制立方样条函数评估 UA 水平与 3 个月时预后良好（改良 Rankin 量表[mRS]评分≤2）和优秀（mRS 评分≤1）结局之间的非线性关系。非线性关系的 值分别为<0.001 和<0.001。然而，对于伴有和不伴有高尿酸血症的患者，UA 水平与 3 个月时预后良好之间未观察到明显的非线性关系，非线性 值分别为 0.299 和 0.207。对应的交互分析得出的 值为 0.001，表明存在显著的异质性。3 个月时预后优秀的结果也得出了类似的结果。在高尿酸血症组中，UA 水平升高 50μmol/L，降低了 3 个月时预后良好的可能性（比值比[OR]，0.75[95%可信区间，0.57-0.97]）。相反，在非高尿酸血症组中，UA 水平的类似增加与更高的预后良好可能性相关（OR，1.31[95%可信区间，1.15-1.50]）。
接受 IVT 治疗的 AIS 患者中，UA 水平与 3 个月时的预后良好和优秀结局之间存在倒 U 型非线性关系。UA 水平较高可预测无高尿酸血症患者的预后良好，但预测高尿酸血症患者的预后不良。
