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Background The level of serum uric acid (SUA) has recently been proven to be associated with outcomes in patients with acute ischemic stroke (AIS) , but whether the association is still controversial. Objective To explore the relationship of baseline SUA level with two-year recurrence and all-cause mortality after first AIS. Methods This retrospective study was conducted with a cohort of inpatients with first AIS treated in Department of Neurology, University of Hong Kong-Shenzhen Hospital from January 1, 2018 to December 31, 2019. The general information, biochemical indicators, and two-year adverse outcome (recurrence and all-cause mortality) after first AIS were collected and a follow up until December 31, 2021. Logistic regression analysis was used to explore the relationship of adverse outcome with quartile of baseline SUA levels〔Q1 group (n=129) , Q2 group (n=129) , Q3 group (n=128) , Q4 group (n=127) 〕 by sex. Results Univariate Logistic regression analysis showed that advanced age, history of diabetes, history of chronic renal insufficiency, high fasting blood glucose and triglyceride levels were risk factors for two-year recurrence and all-cause mortality after first AIS in male patients (P |