Background: Seric uric acid (SUA) is the final product of purine metabo- lism, known as the cause of gout and uratic nephropaty. In the last decades many studies have been performed to investigate its role as a cardio-vascu- lar risk factor and today literature defines SUA as a controversial protective antioxidant resource against cardiovascular diseases that seems to lose this role both in case of lower SUA levels and in hyperuricemia, when antioxi- dant activity is imbalanced into the field of oxidant injury. Methods: We retrospectively collected data from 651 patients with acute stroke followed during the period between 2011 and 2013. Mean age of the sample was 79 years, males represented 47,6%; patients affected by chronic kidney disease were 47.5%. Results: The duration of hospitalization for acute stroke, when related to SUA levels, showed a J-curve distribution, with longer admissions observed among patients with both lower (<4.5 mg/dl) and higher (>7 mg/dl) SUA levels (Fig.1). Kaplan-Meier’s curve showed that patients with levels between 4.5 and 7.0 mg/dl had a significantly better in-hospital survival than patients with low SUA levels (<4.5 mg/dl) and high SUA levels (> 7 mg/dl), as shown in Fig.2 (p<0.0001, log-rank test). Our preliminary analysis un- derline that this result is evident in patients with chronic kidney disease and among males, while in patients with normal renal function and in females only hyperuricemia was associated to a higher risk of in-hospital mortality. Conclusions: Hyperuricemia has well defined role as a cardiovascular risk factor while further studies should be performed to define the role of hypouricemia. Our preliminary data show the importance of mantaining SUA levels within the normal range avoiding both the risks of hypo- and hyper- uricemia, in particular in some subpopulations patients affected by acute ischemic stroke.
The role of uric acid in patients with acute stroke: preliminary report of a large retrospective study
Falsetti L
Writing – Original Draft Preparation
;
2014
Abstract
Background: Seric uric acid (SUA) is the final product of purine metabo- lism, known as the cause of gout and uratic nephropaty. In the last decades many studies have been performed to investigate its role as a cardio-vascu- lar risk factor and today literature defines SUA as a controversial protective antioxidant resource against cardiovascular diseases that seems to lose this role both in case of lower SUA levels and in hyperuricemia, when antioxi- dant activity is imbalanced into the field of oxidant injury. Methods: We retrospectively collected data from 651 patients with acute stroke followed during the period between 2011 and 2013. Mean age of the sample was 79 years, males represented 47,6%; patients affected by chronic kidney disease were 47.5%. Results: The duration of hospitalization for acute stroke, when related to SUA levels, showed a J-curve distribution, with longer admissions observed among patients with both lower (<4.5 mg/dl) and higher (>7 mg/dl) SUA levels (Fig.1). Kaplan-Meier’s curve showed that patients with levels between 4.5 and 7.0 mg/dl had a significantly better in-hospital survival than patients with low SUA levels (<4.5 mg/dl) and high SUA levels (> 7 mg/dl), as shown in Fig.2 (p<0.0001, log-rank test). Our preliminary analysis un- derline that this result is evident in patients with chronic kidney disease and among males, while in patients with normal renal function and in females only hyperuricemia was associated to a higher risk of in-hospital mortality. Conclusions: Hyperuricemia has well defined role as a cardiovascular risk factor while further studies should be performed to define the role of hypouricemia. Our preliminary data show the importance of mantaining SUA levels within the normal range avoiding both the risks of hypo- and hyper- uricemia, in particular in some subpopulations patients affected by acute ischemic stroke.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
