[Association of asymptomatic hyperuricemia with mortality in patients undergoing elective percutaneous coronary...

Objective: This study investigated the influence of asymptomatic hyperuricemia on the prognosis of patients who had undergone elective percutaneous coronary intervention (PCI). Methods: A total of 3 452 consecutive patients , who had preoperative serum uric acid level record and were without gout, underwent elective PCIs between July 2009 and September 2011 were included in this study. Patients were divided into two groups based on their preoperative serum uric acid levels. The association between baseline serum uric acid levels and postoperative mortality was investigated through 1.5 years of follow up. Results: Of the 3 452 patients in the study population, 516 had elevated uric acid and 2 936 had normal uric acid.Patients in the elevated uric acid group were older, more frequently had prior history of hypertension, stroke, myocardial infarction and interventional procedure, less likely to have prior history of diabetes mellitus.Other significant differences included higher white blood cell, total cholesterol and triglyceride levels; lower left ventricular ejection fraction, estimated glomerular filtration rate and high density lipoprotein (HDL) levels, more companied by multivessel disease, more PCI lesions, lower complete revascularization rate.More patients with elevated uric acid level were treated with ACEI/ARB and diuretics at the time of hospital discharge.The results of a multivariate Cox regression analysis revealed that preoperative elevated uric acid was an independent predictive factor for mortality after adjustment for other factors (hazard ratio 3.252, 95% confidence interval 1.902-5.560, P<0.001). Conclusion: Asymptomatic hyperuricemia is an independent predictive factor of mortality in patients undergoing elective PCI.