Uric Acid Variability Is Associated with Poor Prognosis in Heart Failure

Area of Science:

• Cardiology
• Clinical Biochemistry

Background:

• Elevated uric acid (UA) levels are associated with poor heart failure (HF) prognosis.
• Previous research focused on mean UA levels, neglecting the impact of UA fluctuations.

Purpose of the Study:

• To investigate the association between serum UA variability and adverse clinical outcomes in patients with heart failure.
• To determine if UA fluctuations independently predict mortality and HF hospitalizations.

Main Methods:

• Analysis of 18,115 heart failure patients from the SHEBAHEART registry with at least three UA measurements.
• Quantification of UA variability using mean deviation (MD) from average UA levels, categorized into quartiles.
• Utilized Cox regression, propensity score matching, and subgroup analyses to assess outcomes (all-cause mortality, HF hospitalization).

Main Results:

• Over 4.3 years median follow-up, 36% experienced HF hospitalization and 65.5% died.
• Low UA variability (Q1) was associated with reduced mortality (HR 0.79) and HF hospitalization (HR 0.84).
• High UA variability (Q4) was linked to increased mortality (HR 1.58) and hospitalization risk (HR 1.17).

Conclusions:

• Serum UA variability is a significant and independent predictor of mortality and HF hospitalization.
• Serial monitoring of UA levels may improve risk stratification for heart failure management.