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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1378912

Association Between Uric Acid and the risk of Hemorrhagic Transformation in Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

Provisionally accepted
Ying Qian Ying Qian 1Na Li Na Li 1Yuanyuan Li Yuanyuan Li 1Chenxi Tao Chenxi Tao 1Zhenhong Liu Zhenhong Liu 1Guoxia Zhang Guoxia Zhang 2Fan Yang Fan Yang 2Hongrui Zhang Hongrui Zhang 1Yonghong Gao Yonghong Gao 1*
  • 1 Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, Beijing Municipality, China
  • 2 Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    The relationship between hemorrhagic transformation (HT) and uric acid (UA) remains controversial. This study aimed to investigate the relationship between UA concentrations and the risk of HT following acute ischemic stroke (AIS).Methods: Electronic databases were searched for studies on HT and UA from inception to October 31, 2023. Two researchers independently reviewed the studies for inclusion. STATA Software 16.0 was used to compute the standardized mean difference (SMD) and 95% confidence interval (CI) for the pooled and post-outlier outcomes. Heterogeneity was evaluated using the I 2 statistic and the Galbraith plot.Additionally, sensitivity analysis was performed. Lastly, Begg's funnel plot and Egger's test were used to assess publication bias.Results: A total of 11 studies involving 4608 patients were included in the meta-analysis. The pooled SMD forest plot (SMD = -0.313, 95% CI = -0.586--0.039, P = 0.025) displayed that low UA concentrations were linked to a higher risk of HT in post-AIS patients. However, heterogeneity (I 2 = 89.8%, P < 0.001) was high among the studies. Six papers fell outside the Galbraith plot regression line, and there exclusive resulted in the absence of heterogeneity (I 2 = 52.1%, P = 0.080). Meanwhile, repeated SMD analysis (SMD = -0.517, 95% CI = -0.748--0.285, P = 0.000) demonstrated that the HT group had lower UA concentrations. Finally, Begg's funnel plot and Egger's test indicated the absence of publication bias in our meta-analysis.This meta-analysis illustrated a substantial connection between UA concentrations and HT, with lower UA concentrations independently linked with a higher risk of HT post-AIS. These results lay a theoretical reference for future studies.

    Keywords: Acute ischemic stroke, Uric Acid, Hemorrhagic transformation, Correlation, Meta-analysis

    Received: 30 Jan 2024; Accepted: 16 Jul 2024.

    Copyright: © 2024 Qian, Li, Li, Tao, Liu, Zhang, Yang, Zhang and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yonghong Gao, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100001, Beijing Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.