Factors Associated With Hyperuricemia in Patients With Coronary Heart Disease

This study aimed to investigate clinical factors associated with hyperuricemia (HUA) in patients with newly diagnosed coronary heart disease (CHD) and to evaluate the correlation of novel derived biomarkers with HUA, thereby providing a reference for clinical risk identification, prevention, and treatment.

This retrospective study analyzed 2265 patients with newly diagnosed CHD (2019-2024) who were randomly assigned to a modeling group (n = 1812) and a validation group (n = 453); HUA was defined as serum uric acid (UA) ≥420 μmol/L. Least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to identify associated factors. A prediction model was constructed and evaluated using receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration plots.

Independent factors associated with HUA included triglycerides (odds ratio (OR) = 1.097, 95% CI: 1.036-1.160), creatinine (OR = 1.030, 95% CI: 1.025-1.035), monocyte-to-high-density lipoprotein cholesterol ratio (MHR; OR = 1.447, 95% CI: 1.057-1.981), remnant cholesterol (RC; OR = 1.812, 95% CI: 1.406-2.337), and alcohol use (OR = 1.596, 95% CI: 1.202-2.119) (all p < 0.05). The model demonstrated good discrimination with areas under the ROC curve (AUROCs) of 0.781 (0.729-0.832) in the modeling group and 0.780 (0.751-0.808) in the validation group, as well as good calibration and clinical utility at threshold probabilities of 0.22-1.00 and 0.20-0.66, respectively. MHR and RC exhibited a positive nonlinear relationship with HUA risk, with a stronger association for MHR in the hypertensive subgroup (p < 0.05).

MHR and RC are novel biomarkers associated with HUA risk in patients with new-onset CHD. When combined with traditional factors such as triglycerides and creatinine, these novel biomarkers support a multifactorial, integrated evaluation of HUA-related risk and serve as a reference for clinical risk stratification and management.