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Association Between the Uric Acid to High-Density Lipoprotein Cholesterol Ratio and Residual Risk for Coronary Artery

Shan Zhong1,2,3, Siqi Wang1,2,3, Peng Zhao1,2,3

  • 1Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, 150086, China.

Cardiovascular Toxicology
|April 17, 2025
PubMed

Insights

Elevated uric acid to high-density lipoprotein cholesterol ratio (UHR) is linked to increased atherosclerotic plaque burden in coronary artery disease patients. This metabolic-inflammatory marker may help identify individuals at higher risk for plaque progression.

Area of Science:

  • Cardiology
  • Metabolic Syndrome
  • Vascular Biology

Background:

  • Coronary artery disease (CAD) management faces residual risk despite advanced therapies.
  • The uric acid to high-density lipoprotein cholesterol ratio (UHR) is an emerging metabolic-inflammatory marker.
  • The association between UHR and atherosclerotic plaque progression in CAD patients is not well understood.

Purpose of the Study:

  • To investigate the impact of baseline UHR on atherosclerotic plaque burden and progression in patients with newly diagnosed CAD.
  • To determine if UHR can serve as a predictive marker for plaque vulnerability and progression.

Main Methods:

  • Prospective cohort study of 118 CAD patients undergoing percutaneous coronary intervention.
  • Patients stratified into quartiles based on baseline UHR.
  • Intravascular ultrasound used to assess plaque burden and characteristics at baseline and 12-month follow-up.
  • Logistic regression and restricted cubic spline models used for analysis, adjusting for cardiovascular risk factors.

Main Results:

  • Higher baseline UHR quartiles were associated with increased plaque rupture and microchannels.
  • The highest UHR quartile showed greater baseline percent atheroma volume (PAV).
  • Elevated UHR was independently associated with a >70% plaque burden at follow-up (adjusted RR 3.237, P=0.025), with a linear relationship observed.

Conclusions:

  • Elevated UHR is an independent predictor of high atherosclerotic plaque burden in CAD patients receiving guideline-directed therapy.
  • UHR may function as a complementary biomarker to current risk scores.
  • UHR could aid in identifying patients who may benefit from targeted therapies to reduce plaque vulnerability.

Keywords:
Intravascular ultrasoundPlaque burdenResidual riskUHR

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