Association of uric acid with endovascular treatment outcomes in acute ischemic stroke: a cohort study and meta-analysis

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Acute ischemic stroke undergoing endovascular treatment (n=962). Intervention: Higher baseline serum uric acid (Quartile 4: ≥406.0 μmol/L) and dynamic hospitalization uric acid changes (ΔUA) vs. Lowest baseline serum uric acid quartile (Quartile 1: <278.0 μmol/L). Primary outcome: Favorable functional outcome (modified Rankin Scale score 0-2) at day 90 (OR 2.345, 95% CI 1.479-3.717, p=<0.001).

Baoying Song; Hongrui Ma; Yuanyuan Liu; Xiao Dong; Wenbo Hu; Yuan Kan; Yang Zhang; Miaowen Jiang; Yuan Wang; Yi Xu; Ming Li; Chuanjie Wu; Xunming Ji

doi:10.1186/s40001-026-03955-3

February 2, 2026European journal of medical researchOpen Access

Association of uric acid with endovascular treatment outcomes in acute ischemic stroke: a cohort study and meta-analysis

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Key Points

To assess the relationship between baseline uric acid levels and dynamic in-hospital changes with 90-day functional recovery and intracranial hemorrhage in acute ischemic stroke patients undergoing endovascular treatment.
Cohort study enrolling 962 patients with acute ischemic stroke treated with endovascular treatment between January 2015 and January 2024, including 818 patients evaluated for in-hospital uric acid change.
Meta-analysis pooling 3 studies comprising 2353 patients to assess 90-day clinical outcomes across uric acid categories.
In the cohort study, baseline uric acid in quartile 4 (≥406.0 μmol/L) versus quartile 1 was associated with favorable 90-day outcomes (adjusted OR 2.345, 95% CI 1.479-3.717, P<0.001) and lower risk of symptomatic intracranial hemorrhage (adjusted OR 0.297, 95% CI 0.094-0.940, P=0.039).
The largest decline in uric acid during hospitalization (quartile 4: ≥166.0 μmol/L vs quartile 1: <26.0 μmol/L) was associated with fewer favorable outcomes (OR 0.452, 95% CI 0.278-0.735, P<0.001) and increased risk of any intracranial hemorrhage (OR 2.156, 95% CI 1.395-3.331, P<0.001).
In the meta-analysis, the highest uric acid category was positively associated with excellent outcomes at 90 days compared with the lowest category (OR 1.61, 95% CI 1.20-2.16, P=0.001).

Study Design

Type

Cohort (n=962)

Multicenter

No

PICO

P

Population

962 adults (mean age 63.3 years, 30.2% female) with acute ischemic stroke undergoing endovascular treatment (plus 2,353 patients across 3 studies in a companion meta-analysis), followed for 90 days.

E

Exposure / Comparator

Higher baseline serum uric acid (Quartile 4: ≥406.0 μmol/L) and dynamic hospitalization uric acid changes (ΔUA) vs Lowest baseline serum uric acid quartile (Quartile 1: <278.0 μmol/L)

O

Primary Outcome

Favorable functional outcome (modified Rankin Scale score 0-2) at day 90 — OR 2.345 (1.479-3.717), p=<0.001

Main Result

Odds Ratio: 2.345 (95% CI 1.479–3.717)

Absolute Event Rate: 51.8% vs 32.2%

p-value: p=<0.001

Limitations

Single-center retrospective cohort design for the primary clinical dataset
Limited number of independent studies (n=3) included in the meta-analysis with heterogeneity in population characteristics and uric acid detection time points
Lack of data on medications affecting uric acid metabolism such as diuretics and aspirin
Inclusion of unreported single-center cohort data into the meta-analysis

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Implication

Cohort study reveals the link between uric acid levels and stroke treatment outcomes, suggesting important clinical implications.

Abstract

The baseline UA levels and their dynamic changes during hospitalization are correlated with the functional outcomes of stroke and may serve as predictors of intracranial hemorrhage risk and 90-day functional outcome in AIS patients undergoing EVT.

Discussion

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Cite This Study

Song et al. (2026) conducted a cohort in Acute ischemic stroke undergoing endovascular treatment (n=962). Higher baseline serum uric acid (Quartile 4: ≥406.0 μmol/L) and dynamic hospitalization uric acid changes (ΔUA) vs. Lowest baseline serum uric acid quartile (Quartile 1: <278.0 μmol/L) was evaluated on Favorable functional outcome (modified Rankin Scale score 0-2) at day 90 (OR 2.345, 95% CI 1.479-3.717, p=<0.001).

synapsesocial.com/papers/69843383f1d9ada3c1fb0bc5 https://doi.org/10.1186/s40001-026-03955-3

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Association of uric acid with endovascular treatment outcomes in acute ischemic stroke: a cohort study and meta-analysis

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Association of uric acid with endovascular treatment outcomes in acute ischemic stroke: a cohort study and meta-analysis

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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