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Prognostic Value of Different Levels of Uric Acid in Patients with Coronary Chronic Total Occlusion Undergoing

Mohamed Ayoub1, Kambis Mashayekhi2, Michael Behnes3

  • 1Division of Cardiology and Angiology, Heart Center University of Bochum, 32545 Bad Oeynhausen, Germany.

Journal of Clinical Medicine
|June 10, 2023
PubMed

Insights

High uric acid levels predict mortality in patients undergoing percutaneous coronary intervention for chronic total occlusions. Incorporating uric acid into risk assessment may improve outcomes for these patients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Interventional Cardiology

Background:

  • Uric acid (UA) is increasingly recognized as a potential predictor of clinical outcomes after percutaneous coronary intervention (PCI).
  • The prognostic significance of UA in patients undergoing PCI specifically for chronic total occlusions (CTO) remains underexplored.

Purpose of the Study:

  • To investigate the association between pre-procedural uric acid levels and clinical outcomes in patients with CTO undergoing PCI.
  • To determine if uric acid is an independent predictor of all-cause mortality in this specific patient population.

Main Methods:

  • A retrospective analysis of 1963 patients with CTO who underwent PCI between 2005 and 2012.
  • Patients were stratified into three groups based on pre-angiography uric acid tertiles (<5.5 mg/dL, 5.6-6.9 mg/dL, >7.0 mg/dL).
  • Outcomes, including all-cause mortality, were compared among the uric acid tertiles with a median follow-up of 3.0 years.

Main Results:

  • Patients in the lowest uric acid tertile (<5.5 mg/dL) had significantly lower all-cause mortality compared to the highest tertile (>7.0 mg/dL) (adjusted HR: 0.67; 95% CI: 0.49-0.92; p=0.012).
  • No significant difference in all-cause mortality was observed between the first and second uric acid tertiles (adjusted HR: 0.96; 95% CI: 0.71-1.3; p=0.78).
  • Elevated uric acid levels were identified as an independent predictor of all-cause mortality in patients with CTO treated with PCI.

Conclusions:

  • High serum uric acid levels are associated with increased all-cause mortality in patients with chronic total occlusions undergoing percutaneous coronary intervention.
  • Uric acid measurement should be considered as part of the routine risk stratification for patients with CTO undergoing PCI.

Keywords:
chronic total occlusioncoronary artery diseasehyperuricemiamortalitypercutaneous coronary interventionuric acid

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