Prognostic value of serum Uric Acid in-hospital Mortality and Morbidity in Patients with acute Myocardial Infarction

Abstract

Coronary artery disease (CAD) is one of the leading causes of death in the world and also in Bangladesh. This study was carried out to evaluate that Serum uric acid is a prognostic tool in acute myocardial infarction. In this study, 108 AMI cases were enrolled. All the patients were treated and managed identically by conventional standard management protocol. During hospital stay, patients were assessed for any kind of clinical outcomes e.g good recovery, mortality and morbidity (acute LVF, cardiogenic shock, arrhythmia and heart block). Patients with higher serum uric acid (SUA>6.5mg%, Group-II) were compared with Patients with lower serum uric acid (SUA<6.5mg%, Group-I). In Group I (n=66), good recovery, morbidity and mortality were found in 43 (65.2%), 21 (31.8%), 2(3.0%) patients and in Group II (n=42), good recovery, morbidity, mortality were 13 (31%), 23 (54.8%) and 6 (14.3%) patients respectively. In group II patients having high Serum uric acid concentration had low good recovery but high morbidity and mortality compared to group I patients. In group I (n=66), good outcome and bad outcome was found in 43(65.2%), and 23 (34.8%) patients and in group II (n=42), those were in 13 (31%) and 29 (69%) patents. Logistic regression analysis of serum uric acid concentration of study subjects were done considering uric acid as independent variable but outcome as dependent variable. It was shown that the odds ratio of mortality was 5.38(95% CI p<0.007), odds ratio of morbidity was 4.10(95% CI p<0.001) and odds ratio of bad outcome was 4.67(95% CI p<0.001). This findings indicates a patient having high uric acid had 5.38 times increased mortality, 4.10 times increased morbidity and 4.67 times increased bad outcome than patients having low serum uric acid concentration.University Heart Journal Vol. 12, No. 1, January 2016; 8-11

An Observational Study to Assess Outcome of NSTEMI Patients with Raised Serum Uric Acid Level in a Tertiary Care Hospital of Bangladesh

“…But none of the patients of both groups developed mechanical complication. In this regards Hossain et al, (2016) [12], found that cardiogenic shock and acute left ventricular failure were signifi cantly more frequent in hyperuricemia group compared to normal serum uric acid level group (p=0.037 and p=0.004 respectively) whereas arrhythmia and heart block did not differ signifi cantly between two groups (p=0.545 and p=0.629 respectively). The difference may be because of inclusion of all acute Myocardial Infarction cases irrespective of STEMI and NSTEMI in their study but in this study only NSTEMI were included.…”

“…This study is discrepant regarding Killip class and raised serum uric acid from that of Biswas et al This study demonstrated that in-hospital mortality was 7.0% of all NSTEMI with 10.0% patients in group A and 4.0% patients in group B. In-hospital mortality was higher in group A than that of group B but did not reach the level of signifi cance (p>0.05). Hossain, et al (2016) [12], reported in-hospital mortality of acute MI was 7.3% with 14.3% of patients with raised uric acid level and 3% of patients with normal uric acid level. In-hospital mortality of acute MI was signifi cantly higher in patients with raised uric acid level than normal uric acid level (p=0.020).…”

An Observational Study to Assess Outcome of NSTEMI Patients with Raised Serum Uric Acid Level in a Tertiary Care Hospital of Bangladesh

“…This study demonstrated that in-hospital mortality was 7.0% of all NSTEMI with 10.0% patients in group A and 4.0% patients in group B. In-hospital mortality was higher in group A than that of group B but did not reach the level of significance (p>0.05). Hossain et al, (2016) reported in-hospital mortality of acute MI was 7.3% with 14.3% of patients with raised uric acid level and 3% of patients with normal uric acid level [12]. In-hospital mortality of acute MI was significantly higher in patients with raised uric acid level than normal uric acid level (p=0.020).…”

“…In this regards Hossain et al, (2016) found that cardiogenic shock and acute left ventricular failure were significantly more frequent in hyperuricemia group compared to normal serum uric acid level group (p=0.037 and p=0.004 respectively) whereas arrhythmia and heart block did not differ significantly between two groups (p=0.545 and p=0.629 respectively) [12]. The difference may be because of inclusion of all acute Myocardial Infarction cases irrespective of STEMI and NSTEMI in their study but in this study only NSTEMI were included.…”

“…Atherosclerosis is an innate inflammatory disease, inflammatory activity is not confined to just a few atherosclerotic lesions but is present, more or less, in all such lesions throughout the body [12]. As a systemic disease atherosclerosis demands for a systemic approach, focusing on cardiovascular risk factors and the overall burden of disease to ensure appropriate identification and treatment of those who are at highest risk, the so called vulnerable patients.…”