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Predictive Value of Elevated Uric Acid in Turkish Patients Undergoing Primary Angioplasty for ST Elevation Myocardial
Ozgur Akgul1, Huseyin Uyarel2, Hamdi Pusuroglu1
1Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Insights
High uric acid (UA) levels in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) are linked to increased mortality. This finding highlights UA as a significant prognostic marker in STEMI patients.
Area of Science:
- Cardiology
- Biomarkers
- Public Health
Background:
- Uric acid (UA) is an established risk factor for coronary heart disease.
- Serum UA levels correlate with cardiovascular disease mortality, including heart failure and stroke.
- The prognostic value of UA in ST-segment elevation myocardial infarction (STEMI) is not well-defined.
Purpose of the Study:
- To investigate the prognostic significance of admission uric acid levels.
- To evaluate the association between high UA and outcomes in STEMI patients undergoing primary percutaneous coronary intervention (PCI).
Main Methods:
- Prospective enrollment of 434 Turkish STEMI patients undergoing primary PCI.
- Division of patients into high UA (> 5.7 mg/dl) and low UA (≤ 5.7 mg/dl) groups.
- Analysis of clinical characteristics, in-hospital, and six-month outcomes.
Main Results:
- The high UA group had a higher prevalence of Killip class > 1 (17.5% vs. 3.4%).
- In-hospital cardiovascular mortality was significantly higher in the high UA group (12.6% vs. 1.7%).
- Six-month all-cause mortality was substantially greater in the high UA group (19.6% vs. 4.1%).
- High admission UA was an independent predictor of six-month all-cause mortality (HR: 5.57).
Conclusions:
- Elevated admission uric acid levels are associated with increased in-hospital cardiovascular mortality.
- High UA levels predict higher six-month all-cause mortality in STEMI patients treated with primary PCI.
- Uric acid serves as a valuable prognostic marker in this patient population.
Background:
Uric acid (UA) is an independent risk factor for the development of coronary heart disease. Serum UA levels have been correlated with all major forms of death from cardiovascular disease, including acute, subacute, and chronic forms of coronary artery disease (CAD), heart failure, and stroke. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the prognostic value of UA in patients with STEMI undergoing primary percutaneous coronary intervention (PCI).
Methods:
We prospectively enrolled 434 consecutive Turkish STEMI patients (mean age 55.4 ± 12.4 years, 341 male, 93 female) undergoing primary PCI. The study population was divided into tertiles based on admission UA values. The high UA group (n = 143) was defined as a value in the third tertile (> 5.7 mg/dl), and the low UA group (n = 291) included those patients with a value in the lower two tertiles (≤ 5.7 mg/dl). Clinical characteristics, in-hospital and six-month outcomes of primary PCI were analyzed.
Results:
Compared to the low UA group, only Killip class > 1 at admission was more prevalent in the high UA group (3.4% vs. 17.5%, p < 0.001, respectively). Higher in-hospital cardiovascular mortality and six-month all-cause mortality rates were observed in the high UA group than in the lower group (12.6% vs. 1.7%, respectively, p < 0.001) and (19.6% vs. 4.1%, respectively, p < 0.001). In Cox multivariate analysis; a high admission UA value (> 5.7 mg/dl) was found to be a powerful independent predictor of six-month all-cause mortality (hazard ratio: 5.57, 95% confidence interval: 1.903-16.3, p = 0.002).
Conclusions:
These results suggest that a high level of UA on admission was associated with increased in-hospital cardiovascular mortality, and six-month all-cause mortality in Turkish patients with STEMI undergoing primary PCI.
Key Words:
Primary angioplasty; ST elevation myocardial infarction; Uric acid.
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