Serum Uric Acid and Risk of Hemorrhagic Transformation in Patients with Acute Ischemic Stroke

  • Quhong Song
  • Yanan Wang
  • Yajun Cheng
  • Junfeng Liu
  • Chenchen Wei
  • Ming LiuEmail author


Uric acid (UA) is an antioxidant with neuroprotective effects in experimental stroke models. Whether serum UA plays a role in hemorrhagic transformation (HT) remains unclear. We aimed to explore the association between serum UA and HT in patients with acute ischemic stroke (AIS). AIS patients within 7 days after stroke onset were consecutively enrolled between January 2016 and October 2017. Patients were categorized into three groups according to serum UA tertiles by sex. HT was detected by follow-up CT or MRI within 7 days after admission. The multivariate logistic analysis was performed to assess the association of serum UA with HT. We included 1230 patients (mean age 64.1 years, 63.5% males) and 133 (10.8%) patients experienced HT. After adjusting confounders, patients in the second and third UA tertiles showed a significant decrease in HT compared with those in the lowest tertile (OR 0.432, 95% CI 0.266–0.702; OR 0.033, 95% CI 0.013–0.086, respectively). Similar results were observed for sex-based subgroups. Males with higher UA had lower risk of HT compared with the lowest UA tertile (OR 0.332, 95% CI 0.170–0.651; OR 0.008, 95% CI 0.001–0.070, respectively). In females, the highest UA tertile was inversely associated with HT (OR 0.148, 95% CI 0.058–0.376). Multiple-adjusted spline regression analyses further confirmed the dose-response relationship between UA levels and HT. Higher serum UA is independently associated with lower HT following stroke. More studies are needed to elucidate the potential neuroprotective mechanism of serum UA and its link to HT.


Serum uric acid Hemorrhagic transformation Acute ischemic stroke Outcome 


Funding Information

This study was funded by Major International (Regional) Joint Research Project, National Natural Science Foundation of China (81620108009), and Key Research and Development Program, Science & Technology Department of Sichuan Province (2017SZ0007).

Compliance with Ethical Standards

The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the Biomedical Research Ethics Committee of West China Hospital, Sichuan University. Informed consent was obtained from all patients or their next of kin.

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

12031_2019_1404_MOESM1_ESM.docx (50 kb)
ESM 1 (DOCX 50 kb)


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Center of Cerebrovascular Disease, Department of Neurology, West China HospitalSichuan UniversityChengduChina

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