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Prognostic value of uric acid in patients with ST-elevated myocardial infarction undergoing primary coronary

Mehmet G Kaya1, Huseyin Uyarel, Mahmut Akpek

  • 1Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey. drmgkaya@yahoo.com

The American Journal of Cardiology
|November 22, 2011
PubMed

Insights

High uric acid (UA) levels in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention are linked to worse in-hospital and long-term outcomes, including increased mortality.

Area of Science:

  • Cardiology
  • Clinical Research
  • Biomarkers

Background:

  • Elevated uric acid (UA) is linked to cardiovascular disease.
  • The prognostic value of UA in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) is unclear.

Purpose of the Study:

  • To investigate the association between admission UA levels and both in-hospital and long-term adverse outcomes in STEMI patients treated with primary PCI.

Main Methods:

  • Retrospective analysis of 2,249 STEMI patients who underwent primary PCI.
  • Patients were stratified into high-UA and low-UA groups based on sex-specific normal limits.
  • Outcomes assessed included in-hospital mortality, major adverse cardiac events (MACE), cardiovascular mortality, reinfarction, target vessel revascularization, and heart failure.

Main Results:

  • The high-UA group (n=606) had significantly higher in-hospital mortality (9% vs 2%, p<0.001) and adverse outcomes compared to the low-UA group (n=1,643).
  • During a mean follow-up of 24.3 months, the high-UA group experienced significantly higher rates of cardiovascular mortality, reinfarction, target vessel revascularization, heart failure, and MACE.
  • High UA levels were an independent predictor of in-hospital MACE (OR 2.03, 95% CI 1.25-3.75, p=0.006) and long-term MACE (OR 1.64, 95% CI 1.05-2.56, p=0.03).

Conclusions:

  • Admission high uric acid levels are independently associated with adverse in-hospital and long-term outcomes in STEMI patients treated with primary PCI.
  • UA may serve as a valuable prognostic biomarker in this patient population.

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