Relationship of serum uric acid and Killip class on mortality after acute ST-segment elevation myocardial infarction and primary percutaneous coronary intervention

Serum uric acid was an independent predictor of mortality in ST-segment elevation myocardial infarction patients with Killip I other than Killip II-IV Comment on "J Cardiovasc Thorac Res 2016;8:56-60"

“…In contrary, the abundant evidence suggested a significant association between higher SUA and mortality. 2-6 The conflicting results could be explained by that heart failure severity as a complication of the STEMI patients, namely Killip’s classification, were as lower as approximately 20% in the Hajizadeh et al’s study than in other studies that mainly consisted of STEMI patients with Killip I undergoing primary PCI. 1-6 In the PCI era, a higher value of SUA on admission was significantly associated with increased short- and long-term mortality in these studies.…”

“…2-6 The conflicting results could be explained by that heart failure severity as a complication of the STEMI patients, namely Killip’s classification, were as lower as approximately 20% in the Hajizadeh et al’s study than in other studies that mainly consisted of STEMI patients with Killip I undergoing primary PCI. 1-6 In the PCI era, a higher value of SUA on admission was significantly associated with increased short- and long-term mortality in these studies. 5 In our study, we could not either show a significant association between hyperuricemia and mortality in STEMI patients at Killip II-IV, but there was a significant association in the patients with Killip II-IV between hyperuricemia and 1-year mortality.…”

“…5 In our study, we could not either show a significant association between hyperuricemia and mortality in STEMI patients at Killip II-IV, but there was a significant association in the patients with Killip II-IV between hyperuricemia and 1-year mortality. 6 Therefore, the distribution of Killip classification had a great impact on mortality when discussing an effect of SUA in STEMI patients. Actually, the interaction between hyperuricemia and Killip’s classification on mortality had been already pronounced in STEMI patients.…”

“…Actually, the interaction between hyperuricemia and Killip’s classification on mortality had been already pronounced in STEMI patients. 6 We wondered that the result of Hajizadeh et al’s study would be changed if the authors methodologically correct selection bias and focus on the association between SUA and mortality in the Killip I STEMI patient who received primary PCI other than thrombolytic therapies. Conclusively, the relationship among SUA, Killip’s classification and mortality should be considered in STEMI patients, especially in the patients who underwent primary PCI.…”

Serum Uric Acid Levels: A Potential Biomarker for the Acute Myocardial Infarction in Hypertensive Patients

“…The increased concentration of uric acid (UA) in serum, a metabolite of purines degradation produced by activity of xanthine oxidase enzyme, serves as an independent risk factor for cardiovascular disease [6][7][8][9][10][11]. Indeed, the UA has been related to inflammation, endothelial dysfunction and deterioration of left ventricular function via changing calcium sensitivity of myofilaments, alterations of myocardial energetic metabolism, thus serving as major prognostic marker predicting mortality, and needful for heart transplantation in patients with progressive heart failure [12,13].…”