Plasma Uric Acid as a Prognostic Marker in Patients With Hypertrophic Cardiomyopathy

Zhu, Ling; Wang, Jizheng; Wang, Yilu; Jia, Lei; Sun, Kai; Hu, Wang; Zou, Yubao; Tian, Tao; Lu, Yan; Zou, Juan; Hui, Rutai; Yuan, Zuyi; Song, Lei

doi:10.1016/j.cjca.2015.02.018

Cited by 17 publications

(22 citation statements)

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“…Chronic kidney disease is a prominent feature of FD [50]. Our findings are in concordance with a number of studies showing that UA level is a predictor of morbidity and mortality in coronary artery disease [51], heart failure [52], hypertrophic cardiomyopathy [53] and dilated cardiomyopathy [54]. UA has also been incriminated in several cardiovascular, renal and metabolic disease states that frequently occur in Fabry patients, including hypertension [55,56], left ventricular hypertrophy [57], stroke [58], kidney disease [59–61], diabetes and metabolic syndrome [62,63].…”

Section: Discussionsupporting

confidence: 90%

Uric Acid as a Marker of Mortality and Morbidity in Fabry Disease

et al. 2016

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BackgroundSerum uric acid (UA) elevation is common in patients with cardiovascular, renal and metabolic diseases. However, no study to date has analysed the role of UA in Fabry disease (FD).ObjectivesTo evaluate the association between serum UA levels and mortality and morbidity in FD.Materials and MethodsWe conducted a post-hoc analysis of a prospectively followed-up cohort of 124 patients with genetically proven FD. Serum UA levels were acquired at baseline; clinical events and mortality were assessed during regular visits every 6 to 12 months. The primary endpoint was a composite of multiple secondary outcomes: all-cause mortality, adverse cardiovascular events, progression of renal dysfunction and stroke or transient ischaemic attack (TIA). Predictive value was assessed using the Cox proportional hazards model and the Kaplan Meyer estimator.ResultsDuring follow-up of 7.4 ± 3.7 years, 64 (52%) patients reached the primary combined endpoint. Overall, UA levels were significantly associated with combined outcome (p < 0.001) and remained independently associated after correcting for age, sex and estimated glomerular filtration rate (hazard ratio [HR] per 20 μmol/l increase 1.09, 95% confidence interval [95%CI] (1.00–1.19), p = 0.04). UA was associated with overall mortality in univariate analysis (p = 0.021); however, the association did not reach statistical significance after multivariate correction (HR per 20 μmol/l increase 1.07 95%CI 0.93–1.25, p = 0.32). Higher UA levels were also associated with cardiac adverse outcomes, progression of left ventricular hypertrophy and progression of renal dysfunction (ps < 0.001). No association was observed between UA levels and stroke or TIA (p = 0.323).Conclusion and ImplicationsIncreased serum UA levels may represent an independent risk factor for adverse clinical outcomes in Fabry patients and are associated with all-cause mortality. UA is a widely available and cheap biomarker that may improve risk stratification of Fabry patients in clinical practice.

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Section: Discussionsupporting

confidence: 90%

Uric Acid as a Marker of Mortality and Morbidity in Fabry Disease

et al. 2016

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“…In persons with elevated level of HDLc, SUA is associated with an increased risk of idiopathic venous thromboembolism [183]. In patients with hypertrophic cardiomyopathy, SUA is a significant predictor of adverse outcome [184]. Increased SUA was appointed as independent risk factor for overall mortality and CV mortality [185], [186].…”

Section: Uric Acid and Cardiovascular System (Cvs)mentioning

confidence: 99%

Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review

Din

Salem

Abdulazim

2017

Journal of Advanced Research

289

165

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“…HCM is characterized by unexplained LVH, as well as myocyte disarray, replacement fibrosis, and small vessel disease [ 29 ]. Quite recently, uric acid has been reported to be independently associated with adverse prognosis in patients with HCM [ 30 ]. However, the pathophysiological mechanisms underlying this association have not been elucidated.…”

Section: Introductionmentioning

confidence: 99%

Gender-related differences in the association between serum uric acid and left ventricular mass index in patients with obstructive hypertrophic cardiomyopathy

et al. 2016

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BackgroundSerum uric acid (SUA) is associated with left ventricular hypertrophy in a wide spectrum of study population. However, whether this association exists in patients with hypertrophic cardiomyopathy (HCM, including obstructive HCM), and if present, whether gender has any impact on this association, remains unknown.MethodsA total of 161 patients with obstructive HCM (age 47.2 ± 10.8 years, 99 (62 %) men) were included in this study. All patients underwent extensive clinical, laboratory, echocardiographic, and cardiac magnetic resonance (CMR) imaging examinations. Left ventricular mass index (LVMI) was assessed using CMR.ResultsThe mean value of SUA was 353.4 ± 87.5 μmol/L. Both SUA levels (381.2 ± 86.4 vs. 309.0 ± 69.3 μmol/L, p < 0.001) and LVMI (96.2 ± 32.1 vs. 84.4 ± 32.4 g/m2, p = 0.025) were significantly higher in men than in women. LVMI increased progressively across sex-specific tertiles of SUA in women (p = 0.030), but not in men (p = 0.177). SUA was positively correlated with LVMI in female patients (r = 0.372, p = 0.003), but not in males (r = 0.112, p = 0.269). On multivariate linear regression analysis, SUA was independently associated with LVMI in females (β = 0.375, p = 0.002), but not in males.ConclusionsSUA levels are significantly and independently associated with LVMI in women with obstructive HCM, but not in men. Our findings imply the potential significance of urate-lowering regimens in female patients with obstructive HCM.

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Plasma Uric Acid as a Prognostic Marker in Patients With Hypertrophic Cardiomyopathy

Cited by 17 publications

References 40 publications

Uric Acid as a Marker of Mortality and Morbidity in Fabry Disease

Uric Acid as a Marker of Mortality and Morbidity in Fabry Disease

Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review

Gender-related differences in the association between serum uric acid and left ventricular mass index in patients with obstructive hypertrophic cardiomyopathy

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