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Hyperuricemia in Cardiac Rehabilitation Patients: Prevalence and Association with Functional Improvement and Left
Matteo Fortuna1, Chiara Tognola2, Michela Algeri2
1School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Insights
Hyperuricemia (HU) is common in cardiac rehabilitation patients and linked to lower ejection fraction (EF), but not functional improvement. The study used classic and new HU cut-offs, finding the latter increased prevalence without affecting EF association.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- The role of uric acid (UA) and hyperuricemia (HU) in cardiac rehabilitation (CR) patients remains understudied.
- Understanding HU's impact is crucial for optimizing CR outcomes.
Purpose of the Study:
- To determine the prevalence of HU in CR patients.
- To assess the association between HU and functional improvement (6-minute walk test) and left ventricular ejection fraction (EF).
- To compare traditional HU cut-offs with newer URRAH study criteria.
Main Methods:
- 411 patients undergoing CR for Acute or Chronic Coronary Syndrome were enrolled.
- HU was defined using classic (>7 mg/dL males, >6 mg/dL females) and URRAH (>5.6 mg/dL males, >5.1 mg/dL females) cut-offs.
- Patients underwent 6-minute walk tests and echocardiography at admission and discharge.
Main Results:
- Mean UA was 5.6 ± 1.4 mg/dL.
- HU prevalence was 19.5% (classic cut-off) and 47.4% (URRAH cut-off).
- UA and HU (classic cut-off) correlated with admission and discharge EF, but not functional improvement. URRAH cut-off showed no significant EF association.
Conclusions:
- HU is prevalent in CR patients, similar to those with ACS and CCS.
- While HU (classic cut-off) is associated with EF, it does not predict functional recovery.
- The URRAH cut-off identifies more HU cases but lacks significant association with EF in this cohort.
Introduction:
The role of uric acid (UA) and Hyper Uricemia (HU) in cardiac rehabilitation (CR) patients have been very little studied.
Aim:
To evaluate the prevalence of HU and if it is associated to the functional improvement obtained or the left ventricular Ejection Fraction (EF) in CR patients after Acute or Chronic Coronary Syndrome (ACS and CCS respectively).
Methods:
We enrol 411 patients (62.4 ± 10.2 years; males 79.8%) enrolled in the CR program at Niguarda Hospital (Milan) from January 2012 to May 2023. HU was defined both as the classic cut-off (> 6 for females, > 7 mg/dL for males) and with the newly identified one by the URRAH study (> 5.1 for females, > 5.6 mg/dL for males). All patients performed a 6MWT and an echocardiography at the beginning and at the end of CR program.
Results:
Mean UA values were within the normal range (5.6 ± 1.4 mg/dL) with 19.5% (classic cut-off) HU patients with an increase to 47.4% with the newer one. Linear regression analysis showed no role for UA in determining functional improvement, while UA and hyperuricemia (classic cut-off) were associated to admission and discharge EF. The same was not with the URRAH cut-off.
Conclusions:
HU is as frequent in CR patients as in those with ACS and CCS. UA didn't correlate with functional recovery while it is associated with admission and discharge EF as also is for HU (classic cut-off). Whit the URRAH cut-off HU prevalence increases significantly, however, it doesn't show any significant association with EF.
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