A study on association of serum uric acid levels in acute ischemic stroke patients in a tertiary level care hospital, Chennai

 

 

Abstract              Background: For decades the role of Uric acid as a independent risk factor for non-communicable disease is a subject of discussion. Serum Uric acid is a powerful antioxidant that scavenge many harmful free radicals like hydroxyl ions, peroxinitrite along with other anti-oxidants like ascorbic acid .But elevated serum uric acid can act as pro-oxidant that cause various inflammatory reactions .High Serum uric acid can cause endothelial dysfunction, nitric oxide reduction in cells, platelet dysfunction, vascular smooth muscle cells proliferation and activates Renin Angiotensin Aldosterone System. Objective: 1. To study the association between serum uric acid level and acute ischemic stroke patients. 2. To assess the serum uric acid level in the various risk factors of acute ischemic stroke. Methodology: This is an cross sectional study done at Government Royapettah Hospital, Chennai. After obtaining the official permission from Institutional Ethics Committee and informed consent from the patients, the study was conducted. The arrived sample size was 50. Simple random sampling done to arrive at the sample size. The Patients admitted in Govt. Royapettah Hospital with first time acute ischemic stroke were included in the study. Those with Previous history of TIA (Transient Ischemic Attack), CVA(Cerebro Vascular Accident),Patients on Thiazide diuretics, Patients with Malignancies, Patients who are a known case of gout or have clinical evidence of gout, Patients with chronic renal failure, Patients with hemorrhagic stroke are excluded from the study. Serum uric acid levels were measured within 24hours of onset of acute ischemic stroke. Cutoff value of Serum uric acid level was taken as 6.5mg/dl. Other risk factors including Diabetes Mellitus, Hypertension, CAD and hyperlipidemia are evaluated with appropriate lab investigations. The data is entered using MS Excel. Analysed using SPSS Version 16. Descriptive and Inferential statistical analysis done by Chi Square Test, Fisher’s Exact Test, p value less than 0.05 is taken as statistically significant. Results: In the study population 66% were male and 34% were female. 76% were hemiparetic and 24% were hemiplegic. 74% had serum uric acid ≤6.5mg/dl and 26% had serum uric acid levels >6.5mg/dl. The study revealed the strong association between the high serum uric acid levels and Cerebro Vascular Accident (p=0.000*), Diabetes Mellitus(p=0.007*), Systemic Hypertension(p=0.042*), Coronary Artery Disease(p=0.029*), elevated LDL(p=0.046*) and Total Cholesterol levels(p=0.002*). Conclusion: The study shows that uric acid levels may be considered as an independent predictor for ischemic stroke. SUA has a strong association with DM, SHT, CAD and elevated Cholesterol levels. Lowering of SUA level can be considered as one of the preventive modalities for stroke while treating high risk population.

Key Word: Serum Uric Acid, Acute ischemic stroke, anti-oxidant.