A New Predictor of Mortality in ST-Elevation Myocardial Infarction: The Uric Acid Albumin Ratio

Abstract

Several studies have shown that high uric acid (UA) and low serum albumin (SA) values increase the risk of cardiovascular disease and mortality in ST-elevation myocardial infarction (STEMI). We determined whether the uric acid/albumin ratio (UAR) is a predictor of mortality in STEMI patients. All patients who presented at our center with a diagnosis of STEMI and underwent percutaneous intervention from 2015 to 2020 were screened consecutively; 4599 patients were included. A Cox proportional hazards model was used to evaluate UAR, and adjusted predictors obtained from laboratory findings and clinical characteristics contributed to mortality. Also, a regression model was presented with a directed acyclic graph (DAG). The median age of the patients was 58 years (IQR [interquartile range]: 50–67); 3581 patients (77.9%) were male. The incidence of mortality in the entire patient group was 11.9%. Median follow-up duration of all groups was 42 months. Multivariate Cox proportional regression (model-1) analysis showed age (increase 50 to 67 years; HR [hazard ratio]: 1.34, 95% CI 1.18–1.52) and UAR (increase 1.15–1.73; HR: 1.33, 95% CI 1.16–1.52) were associated with mortality. UAR may be a prognostic factor for mortality in STEMI patients and an easily accessible parameter to identify high-risk patients.

Predictive value of uric acid/albumin ratio for the prediction of new-onset atrial fibrillation in patients with ST-Elevation myocardial infarction

“…Furthermore, UAR predicted the severity of CAD better than the CRP-to-albumin ratio (CAR) in patients with non-ST-elevated myocardial infarction 11 . UAR has also been shown to be a predictor of death in STEMI patients, as well as a potential biomarker for identifying high-risk STEMI patients 10 . However, there is a lack of evidence in the literature on the potential role of UAR in predicting the development of NOAF following a STEMI event.…”

“…The uric acid/albumin ratio (UAR) is a novel index, which has recently been developed as a marker of inflammation and oxidative stress. The UAR has been demonstrated to have a good prognostic value in predicting STEMI patients' clinical outcomes 10 . It has also been linked to the extent of CAD in ACS patients 11 .…”

Elevated Serum Uric Acid/Albumin Ratio as a Predictor of Post-Contrast Acute Kidney Injury After Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction

“…As a new predictive index, the prognostic value of the sUAR has been investigated in patients with STEMI, non-ST segment elevation myocardial infarction, and AKI for predicting mortality. 16 , 30 , 31 Yeter et al found that a sUAR > 1.7 was significantly associated with AKI in critically ill patients. 15 Recently, Faysal et al also demonstrated that sUAR (>1.62) had a greater predictive value for contrast-induced nephropathy, and was superior to serum uric acid and albumin.…”

High C-Reactive Protein/Low Serum Albumin: A Hidden Villain in Cardiovascular Disease

“…2,7 When albumin is combined with other risk factors, such as uric acid or CRP, the prognostic value is enhanced. 6,8 On the other hand, normalized albumin levels seem to lower mortality risk compared with hypoalbuminemia. 9 In a similar context, a retrospective study, also published in Angiology, showed that the serum albumin to serum creatinine (sACR) ratio was inversely associated with clinical outcomes in 3057 patients with ST-elevation MI after primary PCI.…”

“…2,7 When albumin is combined with other risk factors, such as uric acid or CRP, the prognostic value is enhanced. 6,8 On the other hand, normalized albumin levels seem to lower mortality risk compared with hypoalbuminemia. 9…”