Serum Uric Acid Levels and Renal Impairment among ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Intervention

Abstract

Background: Elevated serum uric acid (UA) levels are associated with adverse outcomes in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). However, the relation between UA and acute kidney injury (AKI) in this population is unclear. We evaluated the effect of elevated UA levels on the risk to develop AKI among consecutive STEMI patients treated with primary PCI. Methods: We performed a retrospective analysis of 1,372 consecutive patients admitted with the diagnosis of STEMI between January 2008 and February 2015. Patients were stratified into quartiles according to UA levels as follows: quartile 1, <4.7 mg/dl; quartile 2, 4.8 to <5.6 mg/dl; quartile 3, 5.7 to <6.6 mg/dl, and quartile 4, >6.7 mg/dl. Results: STEMI patients with elevated UA levels had a higher frequency of AKI (4 vs. 6% vs. 10 vs. 24%; p < 0.001). In a subgroup analysis of patients with reduced baseline estimated glomerular filtration rate ( ≤ 60 ml/min/1.73 m 2 ), an elevated UA level was associated with a significant risk to develop AKI, with 46% of patients developing AKI in the highest UA quartile. In a multivariate logistic regression model, for every 1-mg/dl increase in the UA concentration, the adjusted risk for AKI increased by 46% (OR = 1.46, 95% CI 1.18-1.66; p < 0.001). Conclusions: Among STEMI patients undergoing primary PCI, elevated UA levels are an independent predictor of AKI.

Uric acid and contrast-induced nephropathy: an updated review and meta-regression analysis

“…The difference in uric acid levels between patients with or without CIN was 0.88 mg/dl, suggesting that even a moderate increase in uric acid levels can be of clinical relevance in this setting. Noteworthy, our findings are in agreement with previous work by Shacham et al , who performed a retrospective analysis of 1,372 consecutive patients with acute myocardial infarction and found that uric acid was an independent predictor of CIN [37]. Interestingly, these authors noted that for every 1-mg/dl increase in the uric acid concentration, the adjusted risk for CIN increased by 46% [37].…”

Correlation of triglycerides with myocardial infarction and analysis of risk factors for myocardial infarction in patients with elevated triglyceride

“…This suggests that hyperglycemia is correlated to the occurrence of MI. In recent years, a number of studies have suggested that serum UA is closely correlated to CVD, and is one of the independent risk factors for CVD (24,25). In this study, with the increase in TG level, UA level also increased, but it was not a risk factor for MI in a population with elevated TG.…”

Elevated Serum Uric Acid/Albumin Ratio as a Predictor of Post-Contrast Acute Kidney Injury After Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction

“…Many studies have demonstrated that serum uric acid, as an inflammatory mediator, is an independent predictor of PC-AKI in patients undergoing PCI. 6 , 7 In contrast, an increased inflammatory response is associated with decreased serum albumin. 8 Serum albumin also has antioxidant properties, and it is associated with the level of renal dysfunction.…”