Hyperuricemia and Its Association With Ischemic Stroke

Abstract

Elevated serum uric acid (SUA) levels have been associated with an increased risk of cardiovascular (CV) disease and acute ischemic stroke (AIS) as well as many other medical conditions. AIS is a CV complication that is the second most common cause of mortality worldwide. It results from reduced blood flow to the brain by means of thrombosis, embolism, or systemic hypoperfusion. Studies have demonstrated an association between SUA levels and CV events, with a significant dose-response relationship between elevated SUA levels and stroke risk. Since the relationship between SUA levels and AIS risk has been established, studies are also being conducted in order to evaluate whether antihyperuricemic drugs can lower this risk. Allopurinol use in hyperuricemic patients has been shown to decrease the risk of major CV events, which include AIS. This narrative review aims to investigate the role of SUA as an independent risk factor for AIS along with the proposed biological mechanisms by thoroughly appraising research findings from relevant full-text articles and abstracts indexed in PubMed and the Cochrane Library. In this literature, we will be discussing hyperuricemia, AIS, the association between the two, and the use of antihyperuricemic medications on stroke prognosis. This review will also shed new light on studies that have begun to provide insight into the predictive role of hyperuricemia in AIS.

Effects of uric acid on ischemic diseases, stratified by lipid levels: a drug-target, nonlinear Mendelian randomization study

“…Additionally, lower serum uric acid levels were causally associated with a decreased risk for cerebral infarction, consistent with previous findings 24 , 25 . Hyperuricemia associated with uric acid deposition is a risk factor for IHD and stroke 26 , 27 . Although the pathophysiological role of uric acid in CVD development remains unclear, several plausible mechanisms have been proposed, including elevated serum uric acid-associated inflammation, oxidative stress, insulin resistance, endothelial dysfunction, and platelet activation, which affect CVD and atherosclerosis progression 28 .…”

Uric acid in atherosclerosis and cardiovascular diseases: innocent bystander or ruthless killer?

“…However, other studies, evaluating patients with previous acute myocardial infarction and already revascularized have failed to confirm this association [90][91][92]. Finally, the ALL-HEART study [93], a large randomized clinical trial, have failed to show benefits on major cardiovascular outcomes from allopurinol treatment in patients with documented CAD without gout. However, it should be taken into account that baseline UA levels in ALL-HEART study were quite normal with a mean of 0.35 mmol/L serum concentrations.…”

COVID-19 pandemic-induced organisational cultural shifts and employee information security compliance behaviour: a South African case study

“…The most conventional cybercrimes have been malware, malicious domains, online fraud, phishing, remote access trojans, ransomware and distributed denial of service attacks (Interpol, 2020; He et al , 2021). Phishing attacks now occur 20,000 to 30,000 times per day and are rising (Padda, 2021). In response many companies focused their resources on securing their corporate network access through Virtual Private Networks and discouraged employees from using public WIFI networks (Georgiadou et al , 2021).…”