Hyperuricemia is Associated With 2- and 5-Year Adverse Outcomes in Patients With ST-Segment Elevation Myocardial
Xiao-Fang Tang1, Chen He2, Pei Zhu1
1Department of Cardiology, Centre for Coronary Heart Disease, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
High uric acid levels (hyperuricemia) predict increased long-term mortality in ST-segment elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). However, hyperuricemia was not linked to inflammation in this patient group.
Area of Science:
- Cardiology
- Biochemistry
- Clinical Medicine
Background:
- Hyperuricemia is an emerging risk factor for cardiovascular diseases.
- The prognostic significance of hyperuricemia in ST-segment elevation myocardial infarction (STEMI) patients is not well-established.
- The potential link between hyperuricemia and inflammation warrants further investigation.
Purpose of the Study:
- To investigate the association between hyperuricemia and long-term prognosis in STEMI patients undergoing percutaneous coronary intervention (PCI).
- To explore the relationship between hyperuricemia and inflammatory markers in STEMI patients.
Main Methods:
- A cohort of 1,448 STEMI patients treated with PCI was analyzed.
- The primary endpoint was all-cause mortality at 2- and 5-year follow-up.
- Admission levels of inflammatory biomarkers (hs-CRP, ESR, WBC) were measured.
Main Results:
- Hyperuricemia was significantly associated with increased 2- and 5-year all-cause mortality in STEMI patients.
- Multivariable analysis confirmed hyperuricemia as an independent predictor of long-term mortality.
- No significant difference in inflammatory markers (hs-CRP, ESR, WBC) was observed between hyperuricemic and normouricemic STEMI patients.
Conclusions:
- Hyperuricemia is linked to a higher risk of long-term death in STEMI patients undergoing PCI.
- This study found no correlation between hyperuricemia and acute inflammatory responses in STEMI patients.
Background:
Hyperuricemia has recently been identified as a risk factor of cardiovascular diseases; however, prognostic value of hyperuricemia in patients with ST-segment elevation myocardial infarction (STEMI) remained unclear. Simultaneously, the mechanism of this possible relationship has not been clarified. At present, some views believe that hyperuricemia may be related to the inflammatory response. Our study aimed to investigate the association between hyperuricemia and long-term poor prognosis and inflammation in STEMI patients undergoing percutaneous coronary intervention (PCI).
Methods:
A total of 1,448 consecutive patients with STEMI were studied throughout 2013 at a single center. The primary endpoint was all-cause death at 2- and 5-year follow-up. Inflammatory biomarkers were collected on admission of those patients: high sensitive C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count.
Results:
Hyperuricemia was associated with higher 2- and 5-year all-cause death in STEME patients compared to normouricemia (5.5% vs. 1.4%, P <0.001; 8.0% vs 3.9%, P = 0.004; respectively). After multivariable adjustment, hyperuricemia was still an independent predictor of 2-year all-cause death (hazard ratio (HR) =4.332, 95% confidence interval (CI): 1.990-9.430, P <0.001) and 5-year all-cause death (HR =2.063, 95% CI: 1.186-3.590, P =0.010). However, there was no difference in hs-CRP, ESR, and WBC count on admission in STEMI patients with hyperuricemia compared to normouricemia (P >0.05).
Conclusions:
Hyperuricemia was associated with higher risks of 2- and 5-year all-cause deaths in patients with STEMI undergoing PCI. However, this study did not find a correlation between hyperuricemia and inflammatory responses in newly admitted STEMI patients.
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