Abstract:
Background: Although a direct causal relationship
between hyperuricaemia and stroke continues to be
debated, strong associations between serum uric acid
(SUA) and cerebrovascular disease exist. Very few
studies have been conducted to evaluate the frequency
and association between this potentially modifiable
biomarker of vascular risk and stroke in sub-Saharan
Africa. Therefore the aim of this study was to examine
the association between hyperuricaemia and the traditional
risk factors and the outcomes of stroke in Ghanaian
patients.
Methods: In this prospective observational study, 147
patients presenting with stroke at a tertiary referral centre
in Ghana were consecutively recruited. Patients
were screened for vascular risk factors and SUA concentrations
measured after an overnight fast. Associations
between hyperuricaemia and stroke outcomes
were analysed using Kaplan-Meier and Cox proportional
hazards regression analysis.
Results: The frequency of hyperuricaemia among
Ghanaian stroke patients was 46.3%. Non-significant
associations were observed between hyperuricaemia
and the traditional risk factors of stroke. SUA concentration
was positively correlated with stroke severity
and associated with early mortality after an acute
stroke with unadjusted hazards ratio of 2.3 (1.4 - 4.2,
p=0.001). A potent and independent dose-response
association between increasing SUA concentration and
hazard of mortality was found on Cox proportional
hazards regression, aHR (95% CI) of 1.65 (1.14-2.39),
p=0.009 for each 100μmol/l increase in SUA.
Conclusions: Hyperuricaemia is highly frequent and
associated with adverse functional outcomes among
Ghanaian stroke patients. Further studies are warranted
to determine whether reducing SUA levels after a
stroke would be beneficial within our setting.