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Impact of Elevated Serum Uric Acid Level on Target Lesion Revascularization After Percutaneous Coronary Intervention

Yoshiyuki Okuya1, Yuichi Saito2, Takefumi Takahashi1

  • 1Department of Cardiovascular Medicine, Tokushima Red Cross Hospital, Tokushima, Japan.

The American Journal of Cardiology
|October 27, 2019
PubMed

Insights

Elevated serum uric acid (SUA) levels are linked to increased target lesion revascularization (TLR) after percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). High SUA is an independent predictor of TLR in these high-risk patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomarkers

Background:

  • Elevated serum uric acid (SUA) is associated with cardiovascular events.
  • The impact of SUA on revascularization in chronic total occlusion (CTO) patients is not well understood.
  • CTO represents a high-risk subset within coronary artery disease.

Purpose of the Study:

  • To investigate the association between baseline SUA levels and target lesion revascularization (TLR) after percutaneous coronary intervention (PCI) for CTO.
  • To identify predictors of TLR in patients undergoing successful CTO PCI.

Main Methods:

  • Retrospective analysis of 165 patients with successful CTO PCI using new-generation drug-eluting stents and intravascular ultrasound guidance.
  • Patients stratified into three groups based on SUA tertiles (low: ≤5.2 mg/dl, intermediate: 5.3-6.4 mg/dl, high: ≥6.5 mg/dl).
  • Primary endpoint was TLR, assessed during a median 34-month follow-up. Coronary angiography and intravascular ultrasound were analyzed.

Main Results:

  • TLR occurred in 8.8% (low SUA), 9.4% (intermediate SUA), and 25.5% (high SUA) of patients (p=0.02).
  • Kaplan-Meier analysis showed a significantly higher TLR incidence in the high SUA tertile group.
  • Multivariable analysis identified SUA ≥6.5 mg/dl, diabetes mellitus, and longer CTO length as independent predictors of TLR.

Conclusions:

  • Elevated SUA levels are associated with an increased risk of TLR after successful drug-eluting stent PCI for CTO.
  • High SUA is an independent predictor of TLR in this high-risk patient population.
  • These findings suggest SUA may play a role in the pathophysiology of restenosis or adverse events after CTO revascularization.

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