Serum uric acid as an independent predictor of mortality in high-risk patients with obstructive coronary artery disease

Lin, Gen‐Min; Li, Yi-Hwei; Zheng, Nan-Cheng; Lai, Cha-Po; Lin, Chin-Lon; Wang, Ji‐Hung; Jaiteh, Lamin E.S.; Han, Chih‐Lu

doi:10.1016/j.jjcc.2012.09.004

Cited by 44 publications

(30 citation statements)

References 32 publications

(35 reference statements)

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“…24 Because this study only used one SNP in the SLC2A9 gene as an instrumental variable, we also calculated CORs and CHRs using a single SNP in SLC2A9 (rs12498742), which is in high linkage disequilibrium with the one used by Palmer et al The COR for prevalent CAD was not significant (data not shown) and estimates for fatal events derived from this analysis were very similar compared with the results obtained for GRS 8 (Supplemental Table 6), which is expected because the SLC2A9 SNP shows by far the strongest association with UA. Regarding all-cause mortality and cardiovascular mortality, most studies find that serum UA is an independent predictor of cardiovascular end points, especially in patients with CAD, 17,30,[33][34][35] but some studies reported the opposite. 29,36,37 Possible explanations for diverging results could be sex-specific effects, 38 an interaction with kidney function, 39 or the possibility that UA might turn pro-oxidant under certain conditions (e.g., CAD).…”

Section: Discussionmentioning

confidence: 99%

Uric Acid and Cardiovascular Events

Kleber

Delgado

Grammer

et al. 2015

Journal of the American Society of Nephrology

238

156

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Obesity and diets rich in uric acid-raising components appear to account for the increased prevalence of hyperuricemia in Westernized populations. Prevalence rates of hypertension, diabetes mellitus, CKD, and cardiovascular disease are also increasing. We used Mendelian randomization to examine whether uric acid is an independent and causal cardiovascular risk factor. Serum uric acid was measured in 3315 patients of the Ludwigshafen Risk and Cardiovascular Health Study. We calculated a weighted genetic risk score (GRS) for uric acid concentration based on eight uric acid-regulating single nucleotide polymorphisms. Causal odds ratios and causal hazard ratios (HRs) were calculated using a two-stage regression estimate with the GRS as the instrumental variable to examine associations with cardiometabolic phenotypes (cross-sectional) and mortality (prospectively) by logistic regression and Cox regression, respectively. Our GRS was not consistently associated with any biochemical marker except for uric acid, arguing against pleiotropy. Uric acid was associated with a range of prevalent diseases, including coronary artery disease. Uric acid and the GRS were both associated with cardiovascular death and sudden cardiac death. In a multivariate model adjusted for factors including medication, causal HRs corresponding to each 1-mg/dl increase in genetically predicted uric acid concentration were significant for cardiovascular death (HR, 1.77; 95% confidence interval, 1.12 to 2.81) and sudden cardiac death (HR, 2.41; 95% confidence interval, 1.16 to 5.00). These results suggest that high uric acid is causally related to adverse cardiovascular outcomes, especially sudden cardiac death.

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Section: Discussionmentioning

confidence: 99%

Uric Acid and Cardiovascular Events

Kleber

Delgado

Grammer

et al. 2015

Journal of the American Society of Nephrology

238

156

View full text Add to dashboard Cite

show abstract

“…This metabolic pathway is source of production of oxygen-free radicals (3). Several recent studies supported the association between serum uric acid (SUA) and cardiovascular diseases (CVDs) (4-8). Increased SUA concentrations are associated with hypertension, atherogenic dyslipidemia, diabetes, age, alcohol consumption and renal failure.…”

Section: Introductionmentioning

confidence: 96%

Serum Uric Acid Could Differentiate Acute Myocardial Infarction and Unstable Angina Pectoris in Hyperuricemic Acute Coronary Syndrome Patients

Hasić¹,

Kadić²,

Kiseljaković³

et al. 2017

Med Arch

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Introduction:Serum uric acid (SUA) is the final product of purine metabolism in humans.Aim:The present study aimed to identify a potential association between serum UA and cardiac troponin I (cTnI) levels and to find out whether uric acid could differentiate patients presenting with the acute myocardial infarction (AMI) and unstable angina pectoris (UAP) in hyperuricemic and normouricemic acute coronary syndrome (ACS) patients.Methods:Eighty ACS patients, aged 50-83 years, were enrolled in the study, 40 of them presenting with AMI and 40 with UAP. Frequency of patients with serum uric level over threshold for hyperuricemia was investigated and two groups of patients were formed such as hyperuricemic and normouricemic groups (A and B groups, respectively) independently of type of ACS. Those groups of patients were also subjected to cTnI measurement.Results:Levels of SUA are associated with the type of ACS in the hyperuricemic ACS patients (AMI versus UAP, 499(458-590), 425(400-447) mmol/L, p=0.007, respectively). Uric acid correlated significantly with cTnI, moderate positively in the group A (rho=0.358, p=0.038) and moderate negatively in the group B (r=-0.309, p=0.037) of ACS patients. Multiple logistic regression analysis revealed that cTnI and age were independently associated with the SUA levels in the group A of ACS patients.Conclusions:Serum uric acid differentiates AIM and UAP patients in hyperuricemic group of acute coronary syndrome. Therefore it can be used as nonspecific parameter for evaluation of the myocardial lesion extent only in hyperuricemic ACS patients. This is supported by finding that cTnI along with age predicts SUA level in hyperuricemic ACS patients.

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“…The SUA level is significantly higher in patients with CAD than in healthy controls [4]. Moreover, multiple prospective studies indicated that elevated SUA level was independently associated with the increased cardiovascular morbidity and mortality in the general population [5] as well as among subjects with significant, angiography defined CAD [6,7] independent of traditional risk factors.…”

Section: Introductionmentioning

confidence: 99%

Lipoprotein subfractions partly mediate the association between serum uric acid and coronary artery disease

Zhang

et al. 2015

Clinica Chimica Acta

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Serum uric acid as an independent predictor of mortality in high-risk patients with obstructive coronary artery disease

Abstract: SUA may be a significant predictor of cardiac and overall mortality, independent of classic risk factors in high-risk patients with obstructive CAD.

Cited by 44 publications

References 32 publications

Uric Acid and Cardiovascular Events

Uric Acid and Cardiovascular Events

Serum Uric Acid Could Differentiate Acute Myocardial Infarction and Unstable Angina Pectoris in Hyperuricemic Acute Coronary Syndrome Patients

Lipoprotein subfractions partly mediate the association between serum uric acid and coronary artery disease

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