Impact of hyperuricemia on 5-year clinical outcomes following percutaneous transluminal angioplasty

Area of Science:

• Cardiovascular Medicine
• Vascular Surgery
• Nephrology

Background:

• The link between hyperuricemia and cardiovascular disease (CVD) is established.
• Limited data exist on hyperuricemia's impact on long-term outcomes in peripheral artery disease (PAD) patients post-percutaneous transluminal angioplasty (PTA).

Purpose of the Study:

• To investigate the association between hyperuricemia and long-term clinical outcomes in PAD patients following PTA.
• To evaluate the impact of elevated uric acid levels on major adverse cardiovascular and limb events.

Main Methods:

• A cohort of 718 PAD patients undergoing PTA was analyzed.
• Patients were classified into hyperuricemia (uric acid ≥7.0 mg/dL [men], ≥6.5 mg/dL [women]) and normal groups.
• Inverse probability weighting (IPTW) was used to adjust for confounders, assessing 5-year major adverse cerebral and cardiovascular events (MACCE) and major adverse limb events (MALE).

Main Results:

• Hyperuricemia was not linked to increased MACCE but showed higher rates of myocardial infarction (MI) and coronary revascularization.
• The hyperuricemia group experienced significantly higher MALE incidence, including target extremity revascularization (TER), non-TER, and target extremity surgery (TES).
• Specific incidences: MI (2.6% vs 0.5%), coronary revascularization (6.7% vs 3.9%), MALE (45.3% vs 28.9%), TER (25.1% vs 15.9%), non-TER (11.5% vs 5.6%), TES (22.8% vs 16.2%).

Conclusions:

• Hyperuricemia is associated with poorer clinical outcomes in PAD patients after PTA over a 5-year follow-up.
• Elevated uric acid levels correlate with increased risks of cardiovascular and limb events.
• Further research is warranted on the potential benefits of managing hyperuricemia to improve patient outcomes.