Association between Uric Acid and In-Hospital Heart Failure in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Abstract

Objective. To investigate the association of serum uric acid levels with in-hospital heart failure (HF) in patients with acute myocardial infarction (AMI) who are undergoing percutaneous coronary intervention (PCI). Methods. Two hundred sixteen patients with AMI who were treated with PCI were enrolled in our study. Univariate and multivariate logistic regression analyses were performed to estimate the associations between uric acid levels and the risk of in-hospital HF in AMI patients. Analyses of the areas under the receiver operating characteristic (ROC) curve were performed to determine the accuracy of uric acid levels in predicting in-hospital HF. Results. A dose-response relationship was found for the incidence of in-hospital HF and levels of uric acid, showing increased HF from the lowest to the highest tertile of uric acid. Compared with subjects in the bottom tertile, the adjusted odds ratio for in-hospital HF was 1.92 (95% CI 0.70–5.24) and 3.33 (95% CI 1.18-9.46) in the second tertile group and the third tertile group, respectively. Every 1 mg/dl increase in the serum uric acid level was associated with a 1.60-fold increased risk of incident in-hospital HF (OR, 1.60; 95% CI 1.22–2.11; P = 0.001 ). ROC curve analysis showed that the optimal cut-off value of uric acid to predict in-hospital HF was 5.75 mg/dl with a sensitivity of 69.2% and specificity of 56.3%. Conclusions. Our study showed that the serum uric acid level on admission is an independent predictor of in-hospital heart failure in patients with AMI.

Uric acid is a biomarker for heart failure, but not therapeutic target: result from a comprehensive meta‐analysis

“…Follow‐up time ranged from 1 to 29 years. These studies were conducted in China, 24 , 25 , 26 Poland, 27 Italy, 28 Japan, 29 USA, 30 , 31 , 32 Turkey, 33 and Korea. 34 Heart failure was diagnosed according to ESC guidelines or based on symptoms, physical signs, and treatment response.…”

Progress of uric acid in cardiovascular disease

“…High variability in UA levels may increase the risk of future CV events, highlighting the necessity of maintaining steady SUA levels and avoiding significant fluctuations after PCI in individuals with CAD [ 59 ]. In addition, a major clinical trial reported that elevated UA on admission markedly raised the risk of in-hospital heart failure in individuals with acute MI undergoing PCI [ 60 ]. Taken together, these studies demonstrate the value of SUA in predicting risk after PCI.…”