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Background <p>The impact of serum uric acid (UA) levels and fluctuations on functional outcomes following endovascular treatment (EVT) for acute ischemic stroke (AIS) is still controversial. This study investigated the relationship between the dynamic changes in UA levels during hospitalization and functional outcomes in patients with AIS who underwent EVT.</p> Methods <p>A single-center retrospective cohort study enrolled 962 AIS patients who received EVT at Xuanwu Hospital from January 2015 to January 2024. Multivariate logistic regression model and restricted cubic spline were used to analyze and explore the correlation between UA levels and functional outcomes. Additionally, a meta-analysis integrated current cohort evidence from three studies, involving 2353 patients. The primary outcome was the favorable outcome (modified Rankin scale scores[mRS] 0–2) during follow-up at day 90. The secondary outcomes included excellent outcome (mRS 0–1), symptomatic intracranial hemorrhage (sICH), any ICH, and all-cause mortality at day 90.</p> Results <p>In this cohort study, a significant inverse U-shaped nonlinear association was observed between baseline UA levels and favorable outcomes. When patients were classified into quartiles by ΔUA (ΔUA, between admission and lowest measurement during hospitalization), patients with the largest decrease in UA had significantly lower proportions of favorable and excellent outcomes at 90&#xa0;days and a higher risk of any ICH, compared to those with an increase or minimal decrease in UA. Meta-analysis results showed that higher baseline UA levels were positively associated with excellent outcomes.</p> Conclusions <p>The baseline UA levels and their dynamic changes during hospitalization are correlated with the functional outcomes of stroke and may serve as predictors of intracranial hemorrhage risk and 90-day functional outcome in AIS patients undergoing EVT.</p>

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Association of uric acid with endovascular treatment outcomes in acute ischemic stroke: a cohort study and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月2日

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  • Baoying Song,
  • Hongrui Ma,
  • Yuanyuan Liu,
  • Xiao Dong,
  • Wenbo Hu,
  • Yuan Kan,
  • Yang Zhang,
  • Miaowen Jiang,
  • Yuan Wang,
  • Yi Xu,
  • Ming Li,
  • Chuanjie Wu,
  • Xunming Ji

摘要

Background

The impact of serum uric acid (UA) levels and fluctuations on functional outcomes following endovascular treatment (EVT) for acute ischemic stroke (AIS) is still controversial. This study investigated the relationship between the dynamic changes in UA levels during hospitalization and functional outcomes in patients with AIS who underwent EVT.

Methods

A single-center retrospective cohort study enrolled 962 AIS patients who received EVT at Xuanwu Hospital from January 2015 to January 2024. Multivariate logistic regression model and restricted cubic spline were used to analyze and explore the correlation between UA levels and functional outcomes. Additionally, a meta-analysis integrated current cohort evidence from three studies, involving 2353 patients. The primary outcome was the favorable outcome (modified Rankin scale scores[mRS] 0–2) during follow-up at day 90. The secondary outcomes included excellent outcome (mRS 0–1), symptomatic intracranial hemorrhage (sICH), any ICH, and all-cause mortality at day 90.

Results

In this cohort study, a significant inverse U-shaped nonlinear association was observed between baseline UA levels and favorable outcomes. When patients were classified into quartiles by ΔUA (ΔUA, between admission and lowest measurement during hospitalization), patients with the largest decrease in UA had significantly lower proportions of favorable and excellent outcomes at 90 days and a higher risk of any ICH, compared to those with an increase or minimal decrease in UA. Meta-analysis results showed that higher baseline UA levels were positively associated with excellent outcomes.

Conclusions

The baseline UA levels and their dynamic changes during hospitalization are correlated with the functional outcomes of stroke and may serve as predictors of intracranial hemorrhage risk and 90-day functional outcome in AIS patients undergoing EVT.