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U-shaped association between serum uric acid concentration and mortality in hypertrophic cardiomyopathy patients

Ziqiong Wang1, Ying Xu1, Hang Liao1

  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

Upsala Journal of Medical Sciences
|February 5, 2020
PubMed

Insights

Both low and high serum uric acid (SUA) levels increase mortality risk in hypertrophic cardiomyopathy (HCM) patients. Optimal SUA concentrations appear to be between 250-350 µmol/L for better survival outcomes.

Area of Science:

  • Cardiology
  • Biochemistry
  • Clinical Medicine

Background:

  • Limited research exists on the impact of low serum uric acid (SUA) on mortality in hypertrophic cardiomyopathy (HCM) patients.
  • Previous studies have not explored the full spectrum of SUA concentrations in relation to HCM mortality.
  • This study investigates the association between both low and high SUA levels and mortality risk in a cohort of HCM patients.

Purpose of the Study:

  • To determine the relationship between serum uric acid (SUA) concentrations and mortality in patients with hypertrophic cardiomyopathy (HCM).
  • To examine the risk of all-cause and HCM-related mortality across the entire range of SUA levels.
  • To identify potential optimal SUA concentration ranges for improved survival in HCM patients.

Main Methods:

  • A retrospective cohort study involving 454 HCM patients.
  • Baseline serum uric acid (SUA) concentrations were measured for all participants.
  • All-cause mortality and HCM-related mortality were recorded as primary and secondary endpoints, respectively.
  • Statistical analyses were performed to assess the association between SUA levels and mortality outcomes.

Main Results:

  • Over a median follow-up of 3.8 years, 17.6% experienced all-cause mortality and 11.5% experienced HCM-related mortality.
  • Patients with SUA concentrations between 250-350 µmol/L exhibited the lowest rates of both all-cause (11.8%) and HCM-related (5.0%) mortality.
  • Both low (<250 µmol/L) and high (≥450 µmol/L) SUA concentrations were significantly associated with increased all-cause and HCM-related mortality.
  • Adjusted hazard ratios for all-cause mortality were 2.52 for low SUA and 2.73 for high SUA, compared to the reference group.
  • Adjusted hazard ratios for HCM-related mortality were 4.86 for low SUA and 4.14 for high SUA, compared to the reference group.

Conclusions:

  • Both low and high serum uric acid (SUA) concentrations are significantly linked to an elevated risk of all-cause and hypertrophic cardiomyopathy (HCM)-related mortality.
  • The findings suggest a U-shaped association between SUA levels and mortality in HCM patients.
  • Maintaining SUA levels within the 250-350 µmol/L range may be crucial for improving survival outcomes in HCM patients.

Keywords:
Hypertrophic cardiomyopathyU-shaped associationmortalityserum uric acid

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