Uric Acid Level and Risk of Symptomatic Intracranial Haemorrhage in Ischemic Stroke Treated with Endovascular Treatment.

Yuan, Kang; Zhang, Xiaohao; Chen, Jingjing; Li, Shun; Yang, Dong; Xie, Yi; Xia, Yaqian; Wu, Min; Wang, Huaiming; Xu, Gelin; Liu, Xinfeng

BACKGROUND There are limited data on the association between uric acid (UA) and symptomatic intracranial haemorrhage (SICH) in patients who have undergone mechanical thrombectomy (EVT). In the present study, we aimed to investigate the role of serum UA level in SICH after EVT in a real-world practice. METHODS Patients were selected from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry (ACTUAL). SICH was identified using the Heidelberg Bleeding Classification. Multivariable logistic regression analysis was performed to explore the relationship between serum UA and SICH. RESULTS Among 611 enrolled patients, 90 (14.7%) were diagnosed with SICH within 72 hours after EVT. Patients with SICH had a significantly higher level of serum UA (median, 341.0 μmol/L versus 302.0 μmol/L; P = 0.003) than those without SICH. Univariate logistic regression analysis indicated that patients with UA levels in the fourth quartile, compared with the first quartile, were more likely to have SICH (odds ratio, 2.846; 95% confidence interval, 1.429-6.003; P = 0.003). The association remained significant after multivariable adjustment for potential confounders. Furthermore, the multiple-adjusted spline regression model showed an inverted U-shape association between UA and SICH (P = 0.047 for nonlinearity). CONCLUSION Our study indicated that increased serum UA level was independently associated with SICH after EVT in acute ischemic stroke.