The Association among Hyperuricemia, Aspirin Resistance, and Ischemic Events Recurrence in Stroke Patients

Abstract Background: It is unclear about the relationship among hyperuricemia, aspirin resistance (AR) and recurrence of ischemic events in ischemic stroke patients. This study focuses on this topic. Methods: In this prospective, observational, and single-center study, acute ischemic stroke (AIS) patients within 14 days of onset were recruited. Every patient took aspirin 100mg/d during the follow-up period, the aspirin reaction unit (ARU) was detected by the VerifyNow System on the 5-7th day, and serum uric acid (SUA) level was also tested. ARU≥550 is defined as AR. Patients were followed up for 3 years and record ischemic events recurrence in the clinical database we built (including transient ischemic attack, ischemic stroke recurrence, major adverse cardiovascular events, and vascular composite death). Results: A total of 138 patients with newly ischemic stroke were recruited in this study, of which 27 were AR and 14 were hyperuricemia. A total of 119 patients completed 3-year follow up, among which 32 patients experienced at least one endpoint, 23 patients had aspirin resistance, and 12 patients had hyperuricemia. Among these 32 patients, no one had hyperuricemia. In the univariate analysis, hyperuricemia was significantly associated with no ischemic events (p=0.035); the incidence of AR was significantly associated with recurrent ischemic events (p=0.012); hyperuricemia has no association with AR (p=0.457). Conclusions: Hyperuricemia might be a protective factor in patients with AIS, and AR has a significant association with ischemic events recurrence which is not associated with hyperuricemia.