The prognostic role of serum uric acid level in patients with acute ST elevation myocardial infarction

Omidvar, Bita; Ayatollahi, Fazlolah; Alasti, Mohammad

doi:10.1016/j.jsha.2012.01.005

Cited by 15 publications

(12 citation statements)

References 8 publications

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“…The inclusion criteria of 8 studies 18 - 20 , 23 , 24 , 26 - 28 were patients who were diagnosed with acute ST-elevation myocardial infarction (STEMI) and underwent PCI subsequently. The inclusion criteria of 2 studies 21 , 22 were patients with STEMI, but did not control their treatment plan. Another three studies 25 , 29 , 30 did not control whether these patients underwent PCI and included patients with STEMI and non-STEMI (NSTEMI) in the cohort.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies (8521 participants) reported short-term mortality, wherein 2 studies 29 , 30 included patients with STEMI and NSTEMI in the cohort and did not control whether these patients underwent PCI; eight studies 18 - 20 , 23 - 28 included only patients with STEMI who underwent PCI. Two studies 21 , 22 included only patients with STEMI, but did not control whether these patients underwent PCI. The HSUA was associated with higher short-term mortality (RR=3.19, 95% CI: 2.68–3.79).…”

Section: Resultsmentioning

confidence: 99%

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High serum uric acid levels may increase mortality and major adverse cardiovascular events in patients with acute myocardial infarction

Zhang

Abeysekera

et al. 2017

SMJ

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Objectives:To determine the validity of uric acid as a potential prognostic marker for long-term outcomes of patients with acute myocardial infarction (AMI) and those with AMI undergoing percutaneous coronary intervention (PCI).Methods:Systematic review and meta-analysis were performed. We retrieved data from retrospective and prospective cohort studies that investigated whether serum uric acid (SUA) level affects the prognosis of patients with AMI.Results:Thirteen studies involving 9371 patients were included. High serum uric acid (HSUA) level increased mid/long-term mortality (risk ratio (RR)=2.32, 95% confidence intervals (CI): 2.00–2.70) and had higher short-term mortality (RR=3.09, 95% CI: 2.58–3.71), higher mid/long-term major adverse cardiovascular events (MACE) risk (RR=1.70, 95% CI: 1.54–1.88), and higher short-term MACE risk (RR=2.47, 95% CI: 2.08–2.92) for patients with AMI. In the PCI subgroup, the HSUA level also increased mid/long-term mortality (RR=2.33, 95% CI: 1.89 to 2.87) and had higher mid/long-term MACE risk (RR=1.64, 95% CI: 1.48–1.82), and higher short-term MACE risk (RR 2.43, 95% CI: 2.02–2.93) for patients who were treated with PCI after AMI. Particularly in the PCI subgroup, a higher short-term mortality (RR=6.70, 95% CI: 3.14–14.31) was presented in the group with lower HSUA cut-off level, and the mortality was higher than the group with higher HSUA cut-off level (RR=2.69, 95% CI: 2.09–3.46).Conclusion:The HSUA level significantly increased the mortality and MACE risk of patients with AMI. Mild elevation of SUA levels (normal range) have started to have a significant impact on the short-term mortality of patients who underwent PCI, and has not received the attention of previous studies. However, this condition should be further investigated.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

High serum uric acid levels may increase mortality and major adverse cardiovascular events in patients with acute myocardial infarction

Zhang

Abeysekera

et al. 2017

SMJ

View full text Add to dashboard Cite

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“… 8 In other study done in Iran higher serum UA had association with in-hospital and short term mortality. 9 By developing new treatments especially increasing trend to invasive therapy in high risk patients for example those who develop heart failure after ST-elevation myocardial infarction (STEMI) and continuous effort to decrease STEMI mortality, it is interesting to investigate whether prognostic factors such as serum UA continue to have their prognostic value or not.…”

Section: Introductionmentioning

confidence: 99%

Association of serum uric acid level with mortality and morbidity of patients with acute ST-elevation myocardial infarction

Hajizadeh

Ghaffari

Salehi

et al. 2016

J Cardiovasc Thorac Res

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Introduction: Investigating the clinical impact of serum uric acid (UA) and its lowering agents on the complications and mortality of acute ST-elevation myocardial infarction (STEMI) can open a new era in STEMI treatment. The aim of this study was to evaluate the effect of on admission serum UA level on the mortality and morbidity of patients admitted with STEMI. Methods: A number of 608 patients with STEMI were enrolled in this study from December 21, 2012 until February 19, 2014. Patients were followed for 20 months. Male to female ratio was 2.53, and the mean age of patients was 62.6±13.4. The relationship between the level of UA and patients’ mortality and morbidity, left ventricular ejection fraction (LVEF), atrial and ventricular arrhythmia was analyzed. Results: Patients with high serum UA level had higher Killip class after STEMI (P=0.001). Mean LVEF was measured to be 39.5±9.6 in normal UA group and 34.6±11.6 in high UA group (P=0.001). In comparison with normal UA group, high UA group had significantly higher cTnI (2.68±0.09 vs 4.09±0.42, respectively, P=0.001), increased blood pressure (P=0.009), and higher atrial fibrillation (AF) occurrence (P=0.03), but no association was seen between ventricular tachycardia and serum UA level. Short term and midterm mortality were not different in two groups (P=0.44 and 0.31, respectively). Conclusion: In the current study, high serum UA level in patients with acute myocardial infarction (MI) was not associated with higher in-hospital or midterm mortality, but it was associated with lower LVEF, higher Killip class, elevated cTnI, creatinine, triglyceride, and higher AF.

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“…High level of uric acid may exert a negative effect on the pathogenesis of CVDs by stimulating inflammation and oxidative stress ( Wang R. et al, 2016 ; Liu et al, 2017 ). Increased circulating uric acid level is recognized as a marker associated with acute ST-segment elevation myocardial infarction in patients ( Omidvar et al, 2012 ; Lazaros et al, 2013 ). Numerous studies have demonstrated that the enhanced inosine acts as a biomarker for acute cardiac ischemia, myocardial infarction in patients and animal models ( Fazekas et al, 1999 ; Farthing et al, 2007 , 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Integration of Metabolomics With Pharmacodynamics to Elucidate the Anti-myocardial Ischemia Effects of Combination of Notoginseng Total Saponins and Safflower Total Flavonoids

Yuan

et al. 2018

Front. Pharmacol.

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Notoginseng (Sanqi), the roots and rhizomes of Panax notoginseng and safflower, the flowers of Carthamus tinctorius, are widely used traditional Chinese medicines (TCMs) for the treatment of cardiovascular diseases. Positive evidences have fueled growing acceptance for cardioprotective effects of the combination of the notoginseng total saponins and safflower total flavonoids (CNS) against myocardial ischemia (MI). However, the underlying cardioprotective mechanisms of CNS are still obscured. Metabolomics is a comprehensive tool for investigating biological mechanisms of disease, monitoring therapeutic outcomes, and advancing drug discovery and development. Herein, we investigated the cardioprotective effects of CNS on the isoproterenol (ISO)-induced MI rats by using plasma and urine metabolomics based on ultra-performance liquid chromatography coupled with quadrupole-time of flight mass spectrometry (UPLC-Q-TOF/MS) and multiple pharmacodynamics approaches. The results showed that pretreatment with CNS could attenuate the cardiac injury resulting from ISO, as evidenced by decreasing the myocardial infarct size, converting the echocardiographic, histopathological, and plasma biochemical abnormalities, and reversing the perturbations of plasma and urine metabolic profiles, particularly for the 55.0 mg/kg dosage group. In addition, 44 metabolites were identified as the potential MI biomarkers, mainly including a range of free fatty acids (FFAs), sphingolipids, and glycerophospholipids. CNS pretreatment group may robustly ameliorate these potential MI-related biomarkers. The accumulation of LysoPCs and FFAs, caused by PLA2, may activate NF-κB pathway and increase proinflammatory cytokines. However, our results showed that CNS at 55.0 mg/kg dosage could maximally attenuate the NF-κB signaling pathway, depress the expressions of TNF-α, IL-6, IL-1β, and PLA2. The results suggested that the anti-inflammatory property of CNS may contribute to its cardioprotection against MI. Our results demonstrate that the integrating of metabolomics with pharmacodynamics provides a reasonable approach for understanding the therapeutic effects of TCMs and CNS provide a potential candidate for prevention and treatment of MI.

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The prognostic role of serum uric acid level in patients with acute ST elevation myocardial infarction

Abstract: Our data suggest that in the acute phase of ST elevation myocardial infarction, uric acid has a prognostic role for in-hospital and short-term (30-day) mortality in men.

Cited by 15 publications

References 8 publications

High serum uric acid levels may increase mortality and major adverse cardiovascular events in patients with acute myocardial infarction

High serum uric acid levels may increase mortality and major adverse cardiovascular events in patients with acute myocardial infarction

Association of serum uric acid level with mortality and morbidity of patients with acute ST-elevation myocardial infarction

Integration of Metabolomics With Pharmacodynamics to Elucidate the Anti-myocardial Ischemia Effects of Combination of Notoginseng Total Saponins and Safflower Total Flavonoids

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