Serum uric acid as an independent predictor of mortality in patients with angiographically proven coronary artery disease

Bickel, Christoph; Rupprecht, Hans J.; Blankenberg, Stefan; Rippin, Gerd; Häfner, Gerd; Daunhauer, Alexander; Hofmann, Klaus-Peter; Meyer, Jürgen

doi:10.1016/s0002-9149(01)02155-5

Cited by 241 publications

(170 citation statements)

References 29 publications

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“…[12][13][14] There are now several reports on the effects of statins (mainly atorvastatin and simvastatin) on renal function and SUA levels as well as their contribution to CHD risk reduction. 8,9,[15][16][17][18][19] ACEIs (Group A and C) had a neutral effect on renal function and SUA levels ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

Effect of statins and ACE inhibitors alone and in combination on clinical outcome in patients with coronary heart disease

et al. 2004

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We assessed the 'synergy' of statins and angiotensinconverting enzyme inhibitors (ACEI) in reducing vascular events in patients with coronary heart disease (CHD). The GREek Atorvastatin and CHD Evaluation (GREACE) Study, suggested that aggressive reduction of low density lipoprotein cholesterol to 2.59 mmol/l (o100 mg/dl) significantly reduces morbidity and mortality in CHD patients, in comparison to undertreated patients. In this post hoc analysis of GREACE the patients (n ¼ 1600) were divided into four groups according to long-term treatment: Group A (n ¼ 460 statin þ ACEI), B (n ¼ 420; statin, no ACEI), C (n ¼ 371;no 371;no statin, on ACEI), and D (n ¼ 349; no statin, no ACEI). Analysis of variance was used to assess differences in the relative risk reduction (RRR) in 'all events' (primary end point) between groups. During the 3-year follow-up there were 292 cardiovascular events; 45 (10% of patients) in group A, 61 (14.5%) in group B, 91 in group C (24.5%) and 95 events in group D (27%). The RRR (95% confidence interval (CI) in the primary end point in group A was 31%, (95% CI À48 to À6%, P ¼ 0.01) in comparison to group B, 59% (95% CI À72 to À48%, Po0.0001) to group C and 63% (95% CI À74 to À51%, Po0.0001) to group D. There was no significant difference in RRR between groups C and D (9%, CI À27-10%, P ¼ 0.1). Other factors (eg the blood pressure) that can influence clinical outcome did not differ significantly between the four treatment groups. In conclusion, the statin þ ACEI combination reduces cardiovascular events more than a statin alone and considerably more than an ACEI alone. Aggressive statin use in the absence of an ACEI also substantially reduced cardiovascular events. Treatment with an ACEI in the absence of a statin use reduced clinical events in comparison to patients not treated with an ACEI but not significantly, at least in these small groups of patients.

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Section: Discussionmentioning

confidence: 99%

Effect of statins and ACE inhibitors alone and in combination on clinical outcome in patients with coronary heart disease

et al. 2004

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“…Previous trials suggest that uric acid might be an independent predictor of major adverse cardiovascular events (MACE) in patients with coronary artery disease or only an indirect marker of adverse event due to the association between uric acid and other cardiovascular risk factors [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Serum Uric Acid As An Independent Predictor of Cardiovascular Event In Patients With Acute ST Elevation Myocardial Infarction

Dharma¹,

Siswanto²

2012

J Clinic Experiment Cardiol

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Background: There is uncertainty whether uric acid level could be used as a prognostic marker in acute ST elevation myocardial infarction (STEMI) patients. Furthermore, there is a need to find a simple, less expensive but accurate marker that could be use in rural areas where fibrinolytic treatment is the first choice of acute reperfusion therapy. We studied the association of uric acid levels on cardiovascular event in patients with STEMI receiving fibrinolytic treatment. Methods:Seventy-five patients with acute STEMI, eligible for fibrinolytic therapy, were enrolled in this cohort study. Over a night of fasting period, uric acid level was measured. One month clinical follow up was done. Reinfarction, heart failure, urgent revascularization, recurrent angina and death were defined as end point of the study. Results:In STEMI patients with lowest uric acid levels (<4.8 mg/dl) compared with highest uric acid levels (>7.3 mg/dl), the cardiovascular event rate increased from 8% to 20%. From multivariate Cox regression analysis showed that elevated levels of uric acid (>7.3 mg/dl) demonstrated an independent, significant positive relation to cardiovascular events [Hazard Ratio 3.10 (95% Confidence Interval 1.16 to 8.29), p <0.024]. Conclusion:Serum uric acid is an independent predictor of cardiovascular event in patients with post fibrinolytic treatment in acute STEMI.

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“…Uric acid is having antioxidant activity in the extracellular environment, once it enters cells including vascular smooth muscle cells (VSMC) and adipocytes, it has detrimental effects 16,17 . Hyperuricemia may predict the development of metabolic syndrome 18 , diabetes mellitus 19 , hypertension 20 , and cardiovascular disorders 21 . These findings support the notion that elevated serum uric acid levels cannot just be viewed as a secondary phenomenon in these pathologies.…”

Section: IIImentioning

confidence: 99%

Association of Serum Uric Acid and ADA Levels in an Obese With or Without Metabolic Syndrome

Prasad¹,

Venkataramana²

2017

IOSR JDMS

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Serum uric acid as an independent predictor of mortality in patients with angiographically proven coronary artery disease

Cited by 241 publications

References 29 publications

Effect of statins and ACE inhibitors alone and in combination on clinical outcome in patients with coronary heart disease

Effect of statins and ACE inhibitors alone and in combination on clinical outcome in patients with coronary heart disease

Serum Uric Acid As An Independent Predictor of Cardiovascular Event In Patients With Acute ST Elevation Myocardial Infarction

Association of Serum Uric Acid and ADA Levels in an Obese With or Without Metabolic Syndrome

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