Asymptomatic hyperuricemia and coronary artery disease in elderly patients without comorbidities

Area of Science:

• Cardiology
• Metabolic Disorders
• Epidemiology

Background:

• Hyperuricemia is common but its independent role in coronary artery disease (CAD) is often obscured by comorbidities.
• Differentiating the impact of hyperuricemia from other cardiovascular risk factors is challenging.

Purpose of the Study:

• To investigate the association between asymptomatic hyperuricemia and the incidence of CAD events in an elderly cohort.
• To determine if hyperuricemia serves as an independent predictor of incident CAD.

Main Methods:

• A cohort of 2,142 subjects aged ≥ 65 years without comorbidities were enrolled.
• Exclusion criteria included obesity, hypertension, diabetes, hyperlipidemia, pre-existing cardiovascular disease, gout, or impaired kidney function (eGFR < 60 mL/min/1.73 m²).
• Poisson regression was used to estimate hazard ratios for incident CAD events in hyperuricemic versus normouricemic individuals.

Main Results:

• The study followed 2,142 subjects for an average of 57.4 months.
• Hyperuricemia was defined as uric acid > 7 mg/dL in men and ≥ 6 mg/dL in women.
• Hyperuricemia was associated with a significantly higher cumulative incidence of CAD events (15.0% vs. 8.8%, P < 0.001).
• After adjustment for confounders, hyperuricemia independently predicted incident CAD events (HR=1.71, 95% CI 1.26-2.34).

Conclusions:

• Asymptomatic hyperuricemia is a significant and independent predictor of incident coronary artery disease events in older adults.
• Elevated uric acid levels can serve as a valuable biomarker for identifying individuals at higher risk of developing CAD.
• These findings emphasize the importance of monitoring uric acid levels in cardiovascular risk assessment, even in the absence of overt comorbidities.