Association Between Serum Uric Acid and Perioperative and Late Cardiovascular Outcome in Patients With Suspected or Definite Coronary Artery Disease Undergoing Elective Vascular Surgery

Dunkelgrün, Martin; Welten, Gijs M.J.M.; Goei, Dustin; Winkel, Tamara A.; Schouten, Olaf; Domburg, Ron T. van; Gestel, Yvette R.B.M. van; Flu, Willem-Jan; Hoeks, Sanne E.; Bax, Jeroen J.; Poldermans, Don

doi:10.1016/j.amjcard.2008.05.019

Cited by 22 publications

(21 citation statements)

References 21 publications

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“…Following CV surgery, uric acid levels may further increase in the immediate postoperative period in response to tissue ischemia or renal injury [17, 18]. In this regard, the increase in SUA might reflect a state of oxidative stress, tissue ischemia, or the presence of renal vasoconstriction [19, 20]. However, recent studies have provided experimental evidence that hyperuricemia may also have potentially negative effects on renal hemodynamics.…”

Section: Discussionmentioning

confidence: 99%

Uric Acid: A Novel Risk Factor for Acute Kidney Injury in High-Risk Cardiac Surgery Patients?

et al. 2009

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Background: Uric acid has been reported to be a risk factor for the development of chronic kidney disease; however, no study has examined whether uric acid may confer a risk for acute kidney injury. Methods: We investigated the relation between serum uric acid and the incidence of postoperative acute kidney injury in patients undergoing high-risk cardiovascular surgery (cardiac valve and aneurysm surgery). Results: Following cardiovascular surgery, 18 of 58 patients (31%) developed acute kidney injury, with 11 of 24 (45.8%) in the elevated uric acid group (defined as >6 mg/dl) and 7 of 34 (20.5%) in the normal uric acid group (p = 0.05). After controlling for baseline renal function, left ventricular ejection fraction, use of nesiritide, type of surgery, and history of previous surgery, an elevated preoperative uric acid conferred a 4-fold risk for acute kidney injury (OR: 3.98, CI: 1.10–14.33, p = 0.035) and longer hospital stay (36.35 vs. 24.66 days, p = 0.009). Conclusion: This preliminary study suggests that uric acid may be a novel risk factor for acute kidney injury in patients undergoing high-risk cardiovascular surgery.

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Section: Discussionmentioning

confidence: 99%

Uric Acid: A Novel Risk Factor for Acute Kidney Injury in High-Risk Cardiac Surgery Patients?

et al. 2009

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“…High serum uric acid (UA) or hyperuricemia has been well demonstrated to be associated with morbidity and mortality in general population [1][2][3] as well as in patients with coronary artery disease [4,5]. It is also associated with poor outcomes in patients with mild to severe heart failure (HF) [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Hyperuricemia predicts adverse outcomes in patients with heart failure

Hamaguchi

Furumoto

Tsuchihashi-Makaya

et al. 2011

International Journal of Cardiology

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“…Patients with renal impairment have decreased excretion of uric acid, and are thus particularly prone to having elevated serum uric acid concentrations (SUACs) and frequently present hyperuricemia (HUR). HUR usually coexists with most common risk factors for worse prognosis; however, uric acid levels are also independently associated with mortality in patients with coronary artery disease [7], heart failure [8] and renal dysfunction [9,10,11]. Recently, it has been indicated that increasing SUACs are strongly related to adverse clinical outcome and higher mortality in patients with AMI.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Hyperuricemia in Patients with Different Types of Renal Dysfunction and Acute Myocardial Infarction Treated with Percutaneous Coronary Intervention

Kowalczyk

Francuz²,

Swoboda³

et al. 2010

Nephron Clin Pract

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Aim: This study evaluated the impact of hyperuricemia (HUR) on outcome in patients with different types of impaired renal function (IRF) and acute myocardial infarction (AMI) treated invasively. Methods: Out of 3,593 consecutive AMI patients treated invasively, 1,015 IRF patients were selected. The IRF group consisted of patients with baseline kidney dysfunction (BKD group) and/or patients with contrast-induced nephropathy (CIN group). HUR was defined as a serum uric acid concentration (SUAC) >420 µmol/l (>7 mg/dl). Independent predictors of death and major adverse cardiovascular events (MACE) were selected by the multivariate Cox-regression model. Results: Remote mortality rates were higher in HUR patients: IRF (32.7 vs. 18.6%), BKD (41.3 vs. 25.9%), CIN (35.4 vs. 16.7%); all p < 0.001. HUR was an independent predictor of death in BKD (hazard ratio (HR) 1.38, p < 0.05). Each 100-µmol/l increase in SUAC was associated with a significant increase of HR for mortality: 1.087 in IRF patients, 1.108 in BKD patients, 1.128 in CIN patients; all p < 0.05. Remote major adverse cardiovascular event rates were higher in HUR patients: IRF (55.4 vs. 48.9%), CIN (56.8 vs. 48%); both p < 0.05. Conclusions: In AMI patients treated invasively, an increase in SUAC is an independent predictor of death within all types of renal dysfunction; HUR defined as SUAC >420 µmol/l (>7 mg/dl) is a predictor only in BKD patients.

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Association Between Serum Uric Acid and Perioperative and Late Cardiovascular Outcome in Patients With Suspected or Definite Coronary Artery Disease Undergoing Elective Vascular Surgery

Cited by 22 publications

References 21 publications

Uric Acid: A Novel Risk Factor for Acute Kidney Injury in High-Risk Cardiac Surgery Patients?

Uric Acid: A Novel Risk Factor for Acute Kidney Injury in High-Risk Cardiac Surgery Patients?

Hyperuricemia predicts adverse outcomes in patients with heart failure

Prognostic Significance of Hyperuricemia in Patients with Different Types of Renal Dysfunction and Acute Myocardial Infarction Treated with Percutaneous Coronary Intervention

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