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Serum Uric Acid Levels and Renal Impairment among ST-Segment Elevation Myocardial Infarction Patients Undergoing
Yacov Shacham1, Amir Gal-Oz2, Nir Flint1
1Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Elevated serum uric acid (UA) levels independently predict acute kidney injury (AKI) in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Higher UA levels significantly increase AKI risk.
Area of Science:
- Cardiology
- Nephrology
- Biochemistry
Background:
- Elevated serum uric acid (UA) is linked to adverse outcomes in ST-segment elevation myocardial infarction (STEMI) patients post-primary percutaneous coronary intervention (PCI).
- The association between UA and acute kidney injury (AKI) in this specific patient group remains incompletely understood.
Purpose of the Study:
- To investigate the impact of elevated serum UA levels on the incidence of AKI in STEMI patients undergoing primary PCI.
Main Methods:
- A retrospective analysis included 1,372 STEMI patients treated with primary PCI from January 2008 to February 2015.
- Patients were stratified into four quartiles based on serum UA levels, ranging from <4.7 mg/dl to >6.7 mg/dl.
Main Results:
- A significant increase in AKI frequency was observed with rising UA levels (4% to 24%; p < 0.001).
- In patients with reduced baseline kidney function (eGFR ≤60 ml/min/1.73 m²), the highest UA quartile showed a 46% AKI incidence.
- Each 1-mg/dl increase in UA concentration correlated with a 46% adjusted increase in AKI risk (OR = 1.46; p < 0.001).
Conclusions:
- Elevated serum UA levels serve as an independent predictor of AKI development in STEMI patients undergoing primary PCI.
- Monitoring UA levels may help identify high-risk individuals for AKI in this population.
Background:
Elevated serum uric acid (UA) levels are associated with adverse outcomes in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). However, the relation between UA and acute kidney injury (AKI) in this population is unclear. We evaluated the effect of elevated UA levels on the risk to develop AKI among consecutive STEMI patients treated with primary PCI.
Methods:
We performed a retrospective analysis of 1,372 consecutive patients admitted with the diagnosis of STEMI between January 2008 and February 2015. Patients were stratified into quartiles according to UA levels as follows: quartile 1, <4.7 mg/dl; quartile 2, 4.8 to <5.6 mg/dl; quartile 3, 5.7 to <6.6 mg/dl, and quartile 4, >6.7 mg/dl.
Results:
STEMI patients with elevated UA levels had a higher frequency of AKI (4 vs. 6% vs. 10 vs. 24%; p < 0.001). In a subgroup analysis of patients with reduced baseline estimated glomerular filtration rate (≤60 ml/min/1.73 m(2)), an elevated UA level was associated with a significant risk to develop AKI, with 46% of patients developing AKI in the highest UA quartile. In a multivariate logistic regression model, for every 1-mg/dl increase in the UA concentration, the adjusted risk for AKI increased by 46% (OR = 1.46, 95% CI 1.18-1.66; p < 0.001).
Conclusions:
Among STEMI patients undergoing primary PCI, elevated UA levels are an independent predictor of AKI.
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