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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

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Decrease in uric acid in acute ischemic stroke correlates with stroke severity, evolution and outcome

Raf Brouns1–3, , / Annick Wauters4 / Gerda Van De Vijver3 / Didier De Surgeloose5 / Rishi Sheorajpanday2, 3 / Peter P. De Deyn2, 3

1Department of Neurology, University Hospital Brussels, Vrije Universiteit Brussel, Brussels, Belgium

2Department of Neurology and Memory Clinic, ZNA Middelheim Hospital, Antwerp, Belgium

3Laboratory for Neurochemistry and Behavior, Institute of Born-Bunge, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium

4Department of Clinical Biology, ZNA Middelheim Hospital, Antwerp, Belgium

5Department of Radiology, ZNA Middelheim Hospital, Antwerp, Belgium

Corresponding author: Prof. Dr. Peter P. De Deyn, Laboratory of Neurochemistry and Behaviour, Institute of Born-Bunge, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium Phone: +32 3 265 26 20, Fax: +32 3 265 26 18,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Issue 3, Pages 383–390, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2010.065, December 2009

Publication History

Published Online:


Background: Although uric acid (UA) is one of the most important antioxidants in plasma and appears to be neuroprotective in animal models, results from human studies are controversial. In this study, we investigated the kinetics of serum UA concentrations in the acute, subacute and chronic phase of ischemic stroke and its relation with initial stroke severity, stroke evolution in the subacute phase and long-term stroke outcome.

Methods: Serum concentrations of UA were measured in 199 stroke patients at admission (median, 2.8 h after stroke onset), at 24 h, 72 h, day 7, month 1 and month 3 after onset of stroke. We evaluated the relationship between changes in UA concentrations and (a) stroke severity [patients with transient ischemic attack (TIA) vs. stroke patients, National Institutes of Health Stroke Scale (NIHSS) score at admission], (b) stroke evolution (stroke progression, infarct volume at 72 h), and (c) stroke outcome [modified Rankin scale (mRS) score at month 3, mortality].

Results: UA concentrations decreased significantly during the first 7 days after stroke onset before returning to baseline (p<0.001). Mean plasma UA concentrations decreased from 336.66±113.01 μmol/L at admission to 300.37±110.04 μmol/L at day 7 (p<0.001) in patients with stroke, but did not change significantly in patients with TIA. Changes in UA concentrations from admission to day 7 (ΔUAday 7) correlated with the NIHSS score (ρ=0.32; p<0.001), stroke progression (ρ=0.29; p=0.001), infarct volume (ρ=0.37; p<0.001), mRS score (ρ=0.28; p=0.001) and mortality (p=0.010).

Conclusions: Decreases in UA during the first week after onset of stroke correlates with more severe stroke, unfavorable stroke evolution, and poor long-term stroke outcome.

Clin Chem Lab Med 2010;48:383–90.

Keywords: acute cerebral infarction; stroke evolution; stroke outcome; stroke severity; uric acid

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