Composite Uric Acid Index for Prediction of Significant Coronary Stenosis on Computed Tomography Angiography

A recently proposed uric acid index combining fasting glucose, triglycerides, and uric acid has shown promise in cardiovascular risk stratification. It was assessed whether the index could predict significant coronary artery stenosis (≥50%) on coronary computed tomography (CT) angiography and compared its diagnostic performance with serum uric acid.

In this retrospective, single-center study, 258 adults who underwent coronary CT angiography between January 2023 and December 2024 were included. Coronary calcification was scored using the Agatston method by 2 cardiologists. Clinical, demographic, and laboratory data were collected. The uric acid index was calculated as Ln [triglycerides × uric acid × glucose/2]. Univariable and hierarchical multiple logistic regression analyses were performed.

Seventy-one patients (27.5%) showed ≥50% stenosis. Those with stenosis were older and had higher Agatston scores, creatinine, uric acid, glucose, HbA1c, and lower high-density lipoprotein cholestrol (HDL-C). In the final multiple models adjusted for age, sex, creatinine and Agatston score, the uric acid index remained a strong independent predictor of ≥50% stenosis (odds ratio [OR] = 1.988, P = .019, 95% confidence interval [CI] = 1.117-3.538). The index demonstrated significant incremental predictive value over the base model, with a Net Reclassification Improvement (NRI) of 0.500 (P < .05) and an Integrated Discrimination Improvement (IDI) of 0.029. The area under the curve for the uric acid index (0.688) exceeded that of uric acid (0.664).

In a real-world coronary CT angiography cohort, the composite uric acid index independently predicted significant coronary stenosis. Its incremental predictive value requires validation in larger, prospective studies.