Association Analysis Between Serum Uric Acid And Hemorrhagic Transformation In Ischemic Stroke Patients Without Reperfusion Therapy

BackgroundThe association between serum uric acid(UA)and hemorrhagic transformation(HT)has been seldom studied,and the role of UA in HT remains unclear.Given the considerable heterogeneity among the participants in previous studies and the time-varying characteristic of UA,this study further investigated the association under the limit of admission time and therapeutic method.MethodWe retrospectively enrolled patients with ischemic stroke in a tertiary academic hospital between December 2016 to May 2020.Patients were included if they presented within 24 hours after onset of symptoms and they did not receive reperfusion therapy.HT was determined by independent evaluation of neuroimaging by three trained neurologists who were blinded to clinical data.Univariate analysis was performed to identify factors related to HT.Four logistic regression models were then established to adjust each factor and assess the association between UA and HT.ResultA total of 769 patients were enrolled(64.6% were males,3.9% had HT).After adjusting the factors with P < 0.05(model A)in the univariate analysis,the ratio of UA and its interquartile range(RUI)was independently associated with HT in males(OR: 1.846;95%CI:1.070–3.185;P = 0.028)but not in females(OR: 1.363;95%CI: 0.306–6.07;P = 0.684).In models B–D,the results remain consistent with model A after following gradual adjustment of other potential confounders.ConclusionHigher serum UA was independently associated with higher occurrence of HT in male patients who were admitted within 24 h after stroke onset without receiving reperfusion therapy.