Effect of Asymptomatic Hyperuricemia on Mortality of Elderly Patients After Elective Percutaneous Coronary
Chen Chen1, Jianzeng Dong1, Qiang Lv1
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Insights
Asymptomatic hyperuricemia increases mortality risk in elderly patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI). This finding highlights the importance of monitoring uric acid levels in this vulnerable population.
Area of Science:
- Cardiology
- Internal Medicine
- Biochemistry
Background:
- Coronary artery disease (CAD) is a leading cause of mortality in the elderly.
- Percutaneous coronary intervention (PCI) is a common treatment for CAD.
- The role of asymptomatic hyperuricemia in post-PCI outcomes requires further investigation.
Purpose of the Study:
- To determine if asymptomatic hyperuricemia is associated with increased mortality in elderly patients after elective PCI.
- To identify hyperuricemia as a potential independent risk factor for adverse outcomes in this patient group.
Main Methods:
- A cohort of 1296 elderly patients (≥65 years) with CAD undergoing elective PCI was analyzed.
- Patients were classified into hyperuricemia (serum uric acid >420 μmol/l for males, >357 μmol/l for females) and non-hyperuricemia groups.
- Mortality rates were compared between groups after an average follow-up of 519 days, with multivariate Cox regression analysis performed.
Main Results:
- The hyperuricemia group (n=236) exhibited higher BMI, hypertension, myocardial infarction history, white blood cells, and triglycerides.
- This group also showed lower estimated glomerular filtration rate and high-density lipoprotein cholesterol.
- Mortality rate was significantly higher in the hyperuricemia group (7.6%) compared to the non-hyperuricemia group (2.2%), P < 0.001.
Conclusions:
- Asymptomatic hyperuricemia is an independent risk factor for increased mortality in elderly patients with CAD following elective PCI.
- Elevated uric acid levels should be considered in risk stratification and management strategies for these patients.
Purpose:
The purpose of this study is to investigate the effect of asymptomatic hyperuricemia on mortality of elderly patients with coronary artery disease (CAD) after elective percutaneous coronary intervention (PCI).
Methods:
One thousand two hundred ninety-six patients with coronary heart disease ≥65 years old who had increased uric acid records and without gout history underwent elective PCI from January 2015 to January 2016 were enrolled. The hyperuricemia is defined as serum uric acid level >420 μ mol/l (7 mg/dl) for males and >357 μ mol/l (6 mg/dl) for females. Patients were divided into hyperuricemia group and non-hyperuricemia group. After an average of 519 days follow-up, the differences in mortality between the two groups were compared.
Results:
There were 236 patients in hyperuricemia group and 1060 patients in non-hyperuricemia group. In hyperuricemia group, BMI was higher (P = 0.036); the proportions of patients with hypertension (P < 0.001) and myocardial infarction history (P = 0.046) were higher; white blood cells (P = 0.015) and triglyceride levels were higher (P < 0.001); and estimated glomerular filtration rate (P < 0.001) and high-density lipoprotein cholesterol level were lower (P = 0.007). In addition, in hyperuricemia group, during hospitalization, the ratios of patients treated with diuretics (P < 0.001) and the number of PCI lesions were higher (P = 0.030), and the complete revascularization rate was lower (P = 0.017). The mortality rate (2.2 vs. 7.6%, P < 0.001) of hyperuricemia group was significantly higher than that of non-hyperuricemia group. Multivariate Cox regression analysis showed that after adjusting for other factors, hyperuricemia was an independent risk factor for increased mortality after PCI (HR 2.786, 95% CI 1.233-6.297, P = 0.014).
Conclusion:
Asymptomatic hyperuricemia is an independent risk factor for increased mortality of elderly patients with coronary heart disease undergoing elective PCI.
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