Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk: 2021 update

Borghi, Claudio; Domienik‐Karłowicz, Justyna; Tykarski, Andrzej; Widecka, Krystyna; Filipiak‬, Krzysztof J.; Jaguszewski, Miłosz; Mancia, Giuseppe

doi:10.5603/cj.a2021.0001

Cited by 52 publications

(65 citation statements)

References 118 publications

(145 reference statements)

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“…Currently, the upper limit of normal for SUA levels is 7 mg/dL (420 µmol/L) for men and 6 mg/dL (360 µmol/L) for women. At the same time, in patients at high cardiovascular risk, the suggested goal is concentrations below 5 mg/dL (297 µmol/L) [ 4 , 5 ]. The cause of hyperuricemia is excessive endogenous uric acid production and decreased uric acid (UA) excretion [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…At the same time, in patients at high cardiovascular risk, the suggested goal is concentrations below 5 mg/dL (297 µmol/L) [ 4 , 5 ]. The cause of hyperuricemia is excessive endogenous uric acid production and decreased uric acid (UA) excretion [ 4 , 5 ]. Overproduction associated with excessive xanthine oxidase (XO) activity may be a consequence of a diet rich in purines and fructose, but also of metabolic disorders and genetic conditions [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…The cause of hyperuricemia is excessive endogenous uric acid production and decreased uric acid (UA) excretion [ 4 , 5 ]. Overproduction associated with excessive xanthine oxidase (XO) activity may be a consequence of a diet rich in purines and fructose, but also of metabolic disorders and genetic conditions [ 4 , 5 ]. The impaired excretion of UA is, in turn, mainly related to kidney function, but may also be the result of the use of certain drugs (e.g., diuretics, non-steroidal anti-inflammatory drugs, etc.)…”

Section: Introductionmentioning

confidence: 99%

“…The impaired excretion of UA is, in turn, mainly related to kidney function, but may also be the result of the use of certain drugs (e.g., diuretics, non-steroidal anti-inflammatory drugs, etc.) [ 4 , 5 ]. In the context of risk factors and diseases of the cardiovascular system, the relationship between hyperuricemia and the occurrence of dyslipidemia, carbohydrate metabolism disorders, abdominal obesity, and metabolic syndrome has so far been confirmed [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Abbreviations* High cardiovascular risk defined as in Borghi et al and described in the Materials and Methods section[4,5].…”

mentioning

confidence: 99%

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Hyperuricemia as a Marker of Reduced Left Ventricular Ejection Fraction in Patients with Atrial Fibrillation: Results of the POL-AF Registry Study

Wełnicki

Gorczyca

Wójcik

et al. 2021

JCM

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Background: Hyperuricemia is an established risk factor for cardiovascular disease, including atrial fibrillation (AF). The prevalence of hyperuricemia and its clinical significance in patients with already diagnosed AF remain unexplored. Methods: The Polish Atrial Fibrillation (POL-AF) registry includes consecutive patients with AF hospitalized in 10 Polish cardiology centers from January to December 2019. This analysis included patients in whom serum uric acid (SUA) was measured. Results: From 3999 POL-AF patients, 1613 were included in the analysis. The mean age of the subjects was 72 ± 11.6 years, and the mean SUA was 6.88 ± 1.93 mg/dL. Hyperuricemia was found in 43% of respondents. Eighty-four percent of the respondents were assigned to the high cardiovascular risk group, and 45% of these had SUA >7 mg/dL. Comparison of the extreme SUA groups (<5 mg/dL vs. >7 mg/dL) showed significant differences in renal parameters, total cholesterol concentration, and left ventricular ejection fraction (EF). Multivariate regression analysis showed that SUA >7 mg/dL (OR 1.74, 95% CI 1.32–2.30) and GFR <60 mL/min/1.73 m2 (OR 1.94, 95% CI 1.46–2.48) are significant markers of EF <40% in the study population. Female sex was a protective factor (OR 0.74, 95% CI 0.56–0.97). The cut-off point for SUA with 60% sensitivity and specificity indicative of an EF <40% was 6.9 mg/dL. Conclusions: Although rarely assessed, hyperuricemia appears to be common in patients with AF. High SUA levels may be a significant biomarker of reduced left ventricular EF in AF patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Abbreviations* High cardiovascular risk defined as in Borghi et al and described in the Materials and Methods section[4,5].…”

mentioning

confidence: 99%

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Hyperuricemia as a Marker of Reduced Left Ventricular Ejection Fraction in Patients with Atrial Fibrillation: Results of the POL-AF Registry Study

Wełnicki

Gorczyca

Wójcik

et al. 2021

JCM

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Evaluation of the Effect of Topiroxostat on Renal Function in Patients with Hyperuricemia: STOP-C Study, a Retrospective Observational Cohort Study

Tamiya

Yamashita

Takabe

et al. 2022

Drugs - Real World Outcomes

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Background Serum uric acid-lowering therapy is associated with maintaining renal function. Objective We aimed to retrospectively evaluate renal function and serum uric acid in patients with hyperuricemia who received topiroxostat for over a year. Methods Medical records of patients from 1 January, 2015 to 31 October, 2019 in our hospital were used. From the medical records, data of 100 patients with hyperuricemia treated with topiroxostat were extracted (67:33 male:female). The primary endpoints were changes in serum creatinine level and estimated glomerular filtration rate at 12 months after topiroxostat administration. The secondary endpoints were changes in serum creatinine, serum uric acid, and estimated glomerular filtration rate before and after topiroxostat administration. ResultsThe study mainly involved elderly individuals (77.2 ± 9.5 years). Forty-four patients administered uric acid-lowering drugs were switched to topiroxostat. After 12 months, the serum creatinine level and estimated glomerular filtration rate showed no significant changes from baseline; however, the serum uric acid level significantly decreased. The estimated glomerular filtration rate significantly decreased during the 6 months before topiroxostat administration (p < 0.001), but showed no significant change at 6 months after topiroxostat administration (p = 0.849). Conclusions This study revealed that topiroxostat use not only reduced the serum uric acid level but also maintained renal function in elderly patients with hyperuricemia in daily clinical practice.

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Hyperuricaemia-associated all-cause mortality risk effect is increased by non-impaired kidney function – Is renal hyperuricaemia less dangerous?

Timsans,

Kauppi,

Kerola

et al. 2024

European Journal of Internal Medicine

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Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk: 2021 update

Cited by 52 publications

References 118 publications

Hyperuricemia as a Marker of Reduced Left Ventricular Ejection Fraction in Patients with Atrial Fibrillation: Results of the POL-AF Registry Study

Hyperuricemia as a Marker of Reduced Left Ventricular Ejection Fraction in Patients with Atrial Fibrillation: Results of the POL-AF Registry Study

Evaluation of the Effect of Topiroxostat on Renal Function in Patients with Hyperuricemia: STOP-C Study, a Retrospective Observational Cohort Study

Hyperuricaemia-associated all-cause mortality risk effect is increased by non-impaired kidney function – Is renal hyperuricaemia less dangerous?

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