Early onset of hyperuricemia is associated with increased cardiovascular disease and mortality risk

Li, Lijun; Zhao, Maoxiang; Wang, Chi; Zhang, Sijin; Yun, Cuijuan; Chen, Si; Wu, Shouling; Xue, Hao

doi:10.1007/s00392-021-01849-4

Cited by 34 publications

(25 citation statements)

References 44 publications

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“…Recently, the relationship between HUA and CV outcomes has received a large amount of attention. As reported, early onset of HUA was associated with increased CVD and mortality risk in the general population [ 15 ]. A large cohort study showed that stable high UA was correlated with an increased higher risk of MI [ 16 ].…”

Section: Discussionmentioning

confidence: 73%

“…Elevated UA levels are closely linked with hypertension, diabetes, obesity, metabolic syndrome, and kidney diseases [ 11 – 14 ]. More importantly, emerging evidence indicates that hyperuricemia (HUA) is commonly seen and is an independent predictor of mortality and adverse CV events in general population [ 15 – 19 ]. Recent studies further verified the prognostic value of HUA in various subgroups with coronary artery disease (CAD), including stable CAD, acute coronary syndrome (ACS), and those undergoing percutaneous coronary intervention (PCI) [ 20 – 26 ], whereas some studies failed to confirm this association [ 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Hyperuricemia as a prognostic marker for long-term outcomes in patients with myocardial infarction with nonobstructive coronary arteries

et al. 2021

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Background Hyperuricemia (HUA) has been proved as a predictor of worse outcomes in patients with coronary artery disease. Here, we investigated the prognostic value of HUA in a distinct population with myocardial infarction with nonobstructive coronary arteries (MINOCA). Methods A total of 1179 MINOCA patients were enrolled and divided into HUA and non-HUA groups. HUA was defined as a serum uric acid level ≥ 420 μmol/L in men or ≥ 357 μmol/L in women. The primary study endpoint was a composite of major adverse cardiovascular events (MACE), including all-cause death, nonfatal MI, nonfatal stroke, revascularization, and hospitalization for unstable angina or heart failure. Kaplan–Meier, Cox regression, and receiver-operating characteristic analyses were performed. Results Patients with HUA (prevalence of 23.5%) had a significantly higher incidence of MACE (18.7% vs. 12.8%; p = 0.015) than patients without during the median follow-up of 41.7 months. HUA was closely associated with an increased risk of MACE even after multivariable adjustment (hazard ratio 1.498, 95% confidence interval: 1.080 to 2.077; p = 0.016). HUA remained a robust risk factor of MACE after propensity score matching analysis. Moreover, HUA showed an area under the curve (AUC) of 0.59 for predicting MACE. Incorporation of HUA to the thrombolysis in myocardial infarction (TIMI) score yielded a significant improvement in discrimination for MACE. Conclusions HUA was independently associated with poor prognosis after MINOCA. Routine assessment of HUA may facilitate risk stratification in this specific population.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Hyperuricemia as a prognostic marker for long-term outcomes in patients with myocardial infarction with nonobstructive coronary arteries

et al. 2021

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“…Furthermore, in HF, low blood pressure is a problem that often discourages physicians from prescribing guideline-guided therapies. This is related to a fear of adverse drug effects as most of effective HF agents and to the fact that low blood pressure associates with poor prognosis [ 10 – 12 ]. Since SGLT2 inhibitors also lower blood pressure in hypertensive patients [ 13 ], there was concern that SGLT2 inhibitors also lower blood pressure in HF to a range that leads to intolerance [ 14 ].…”

Section: Novel Heart Failure Treatmentsmentioning

confidence: 99%

Timely and individualized heart failure management: need for implementation into the new guidelines

et al. 2021

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Due to remarkable improvements in heart failure (HF) management over the last 30 years, a significant reduction in mortality and hospitalization rates in HF patients with reduced ejection fraction (HFrEF) has been observed. Currently, the optimization of guideline-directed chronic HF therapy remains the mainstay to further improve outcomes for patients with HFrEF to reduce mortality and HF hospitalization. This includes established device therapies, such as implantable defibrillators and cardiac resynchronization therapies, which improved patients' symptoms and prognosis. Over the last 10 years, new HF drugs have merged targeting various pathways, such as those that simultaneously suppress the renin–angiotensin–aldosterone system and the breakdown of endogenous natriuretic peptides (e.g., sacubitril/valsartan), and those that inhibit the If channel and, thus, reduce heart rate (e.g., ivabradine). Furthermore, the treatment of patient comorbidities (e.g., iron deficiency) has shown to improve functional capacity and to reduce hospitalization rates, when added to standard therapy. More recently, other potential treatment mechanisms have been explored, such as the sodium/glucose co-transporter inhibitors, the guanylate cyclase stimulators and the cardiac myosin activators. In this review, we summarize the novel developments in HFrEF pharmacological and device therapy and discuss their implementation strategies into practice to further improve outcomes.

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“…Considering the complex composition, the dysfunction of these cells in the heart and vasculature contributes to the pathogenesis of CVDs. CVDs might be triggered by multiple processes, such as mitochondrial dysfunction, reactive oxygen species formation, abnormal calcium homeostasis, deleterious phosphorylation signaling, proteostasis imbalance, dysregulated nutrient sensing, cellular senescence, stem cell exhaustion, genomic instability, telomere attrition, and epigenetic alterations (7,8). With the rapid advance in biochemical, molecular, and high-throughput sequencing technologies, the dysregulated expression profiles of the human genome in CVD patients have focused on (9).…”

Section: Introductionmentioning

confidence: 99%

Histone Methylation Related Therapeutic Challenge in Cardiovascular Diseases

Yang

Luan

Yuan

et al. 2021

Front. Cardiovasc. Med.

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The epidemic of cardiovascular diseases (CVDs) is predicted to spread rapidly in advanced countries accompanied by the high prevalence of risk factors. In terms of pathogenesis, the pathophysiology of CVDs is featured by multiple disorders, including vascular inflammation accompanied by simultaneously perturbed pathways, such as cell death and acute/chronic inflammatory reactions. Epigenetic alteration is involved in the regulation of genome stabilization and cellular homeostasis. The association between CVD progression and histone modifications is widely known. Among the histone modifications, histone methylation is a reversible process involved in the development and homeostasis of the cardiovascular system. Abnormal methylation can promote CVD progression. This review discusses histone methylation and the enzymes involved in the cardiovascular system and determine the effects of histone methyltransferases and demethylases on the pathogenesis of CVDs. We will further demonstrate key proteins mediated by histone methylation in blood vessels and review histone methylation-mediated cardiomyocytes and cellular functions and pathways in CVDs. Finally, we will summarize the role of inhibitors of histone methylation and demethylation in CVDs and analyze their therapeutic potential, based on previous studies.

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Early onset of hyperuricemia is associated with increased cardiovascular disease and mortality risk

Cited by 34 publications

References 44 publications

Hyperuricemia as a prognostic marker for long-term outcomes in patients with myocardial infarction with nonobstructive coronary arteries

Hyperuricemia as a prognostic marker for long-term outcomes in patients with myocardial infarction with nonobstructive coronary arteries

Timely and individualized heart failure management: need for implementation into the new guidelines

Histone Methylation Related Therapeutic Challenge in Cardiovascular Diseases

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