Gender Differences in the Role of Serum Uric Acid for Predicting Cardiovascular Events in Patients with Coronary Artery Disease

Abstract

Background and Objectives：Serum uric acid has been reported to be an independent risk factor for coronary artery disease (CAD) and a predictor of mortality in patients with CAD. Yet there is gender difference for the serum uric acid levels. We evaluated the influence of the uric acid levels on major adverse cardiovascular events (MACEs) in patients with CAD according to their gender. Subjects and Methods：Of the 777 patients with angiographically proven CAD, 660 patients (378 males, 57.3%) were followed up a median of 18 month (maximum: 61 month). The MACEs included acute myocardial infarction, cerebral infarction, coronary artery bypass graft, percutaneous coronary intervention due to de novo lesion during follow up, new onset congestive heart failure and sudden cardiac death. Results：MACEs in men were associated with acute coronary syndrome (ACS)(odds ratio (OR): 2.03, 95% confidence intervals (CI): 1.01 to 3.96, p=0.038), multi-vessel disease (OR: 3.68, 95% CI: 1.82 to 7.47, p=0.000) and the serum uric acid levels (OR: 1.23, 95% CI: 1.01 to 1.50, p=0.044), according to multivariate Cox regression analysis. For women, MACEs were associated with multi-vessel disease (OR: 2.43, 95% CI: 1.15 to 5.13, p=0.020) and the highest uric acid quartile (OR: 2.64, 95% CI: 1.31 to 5.30, p=0.006) according to multivariate Cox regression analysis. For all patients, the highest uric acid quartile was associated with an increased risk of MACE (p=0.000), and CHF was the major contributor to the observed MACEs (p=0.004). Conclusion：In male patients with CAD, the serum uric acid level is a predictor of cardiovascular events, and the highest uric acid quartile is a predictor of cardiovascular events in women. (Korean Circulation J 2007;37: [196][197][198][199][200][201]

Serum Uric Acid Is Not an Independent Risk Factor for Premature Coronary Artery Disease

“…It has also been demonstrated that serum uric acid levels predicted cardiovascular events in male patients with CAD, and only the highest uric acid quartile was a predictor of cardiovascular events in women [32]. However, there was no relationship between uric acid and premature CAD within each gender group in the present study.…”

Hyperuricemia and risk of stroke: A systematic review and meta‐analysis

“…Of the 65 screened abstracts, 22 studies were retrieved for detailed evaluation. Of those 22, 2 studies were based on the same patient population, so they were considered as 1 study in the meta‐analysis (21, 22). One study was excluded because it reported insufficient data on stroke outcome (23).…”

LC/MS-based polar metabolite profiling reveals gender differences in serum from patients with myocardial infarction

“…They suggested that hypoxia was associated with a remarkable increase in hypoxanthine and inosine. Additionally, serum uric acid, the final product of purine metabolites, has been reported to be a predictor of mortality and morbidity in patients with MI [60], and is affected with sex differences [61,62]. However, no previous studies have investigated the influences of uric acid precursors on gender differences in MI.…”