Relationship between admission serum uric acid to lymphocyte ratio and the risk of ischemic stroke recurrence and death: a prospective study.

Abstract

Background: This study aims to explore the relationship between the Serum uric acid to lymphocyte ratio (ULR) level at admission and the long-term risk of recurrence and death in patients with acute ischemic stroke (AIS) in Liaoning Province.

Methods: This multicentre prospective study enrolled 7966 subjects who experienced ischemic stroke (IS) across Liaoning Province, China. The Cox proportional hazards model and Kaplan-Meier curves were used to explore the association of ULR with the risk of recurrence and death in IS.

Results: During a median follow-up period of 4.08 (3.35, 4.43) years, there were 1311 cases of stroke recurrence or death, 1429 cases of cardiovascular (CVD) death, and 910 cases of stroke-cause death. In analysis comparing the Q4 and Q1group, after multivariate adjustment, ULR was significantly positively associated with the incidence of stroke recurrence or death (Q4 vs. Q1: HR = 1.21; 95% CI = 1.04, 1.42), CVD death (Q4 vs. Q1: HR = 1.16; 95% CI = 1.00, 1.34), and stroke-cause death (Q4 vs. Q1: HR = 1.26; 95% CI = 1.05, 1.52). Additionally, the significant correlation between ULR and the risk of IS recurrence or death was partially mediated by diastolic blood pressure (DBP) (8.53%) and systolic blood pressure (SBP) (3.59%) in a positive manner.

Conclusions: This study demonstrates that higher ULR is significantly associated with an increased risk of recurrence and death following IS. The findings suggest that ULR could serve as a valuable prognostic marker in clinical practice, particularly in managing patients with IS.