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Impact of hyperuricemia on clinical outcomes after percutaneous coronary intervention for in-stent restenosis

Hyung Joon Joo1, Han Saem Jeong1, Hyungdon Kook1

  • 1Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, 126-1, 5ka, Anam-dong, Sungbuk-ku, Seoul, 136-705, Republic of Korea.

BMC Cardiovascular Disorders
|June 13, 2018
PubMed

Insights

Hyperuricemia did not impact clinical outcomes after repeat percutaneous coronary intervention for in-stent restenosis. Higher low-density lipoprotein cholesterol and lower ejection fraction were independent predictors of major adverse events.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Nephrology

Background:

  • Limited data exist on hyperuricemia's impact on long-term outcomes following percutaneous coronary intervention (PCI) for in-stent restenosis (ISR).
  • Understanding this relationship is crucial for managing patients with recurrent coronary artery disease.

Purpose of the Study:

  • To investigate the association between serum uric acid (UA) levels and clinical outcomes in patients undergoing repeat PCI for ISR.
  • To identify independent predictors of major adverse events (MAE) in this patient cohort.

Main Methods:

  • A cohort of 317 patients undergoing repeat PCI for ISR between January 2009 and July 2015 were categorized into normal UA and higher UA groups.
  • Higher UA was defined as serum UA > 6.8 mg/dL or use of anti-hyperuricemic medication.
  • Patients were followed for a median of 1088 days to assess MAE (all-cause death, non-fatal myocardial infarction, any revascularization) and angiographic outcomes.

Main Results:

  • Cumulative MAE rates were similar between the higher UA (36.4%) and normal UA (29.9%) groups (p=0.389).
  • Angiographic outcomes, including late lumen loss and binary restenosis rates, were also comparable between groups.
  • Multivariate analysis identified elevated low-density lipoprotein cholesterol (LDL-C) and reduced left ventricular ejection fraction (LVEF) as independent predictors of MAE, while UA levels were not significant.

Conclusions:

  • Hyperuricemia is not associated with adverse long-term clinical or angiographic outcomes after repeat PCI for ISR.
  • Elevated LDL-C and reduced LVEF are significant independent risk factors for MAE in patients with ISR undergoing repeat PCI.
Abstract

Keywords:
In-stent restenosisMajor adverse eventPercutaneous coronary interventionUric acid

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