Korean Circ J.  2007 Apr;37(4):161-166. 10.4070/kcj.2007.37.4.161.

Serum Uric Acid is Associated with Cardiovascular Events in Patients with Coronary Artery Disease

Affiliations
  • 1Division of Cardiology, Konyang University Hospital, Daejeon, Korea. janghobae@yahoo.co.kr
  • 2Mayo Clinic, Rochester, MN, USA.

Abstract

BACKGROUND AND OBJECTIVES: Whether uric acid is a predictor of cardiovascular events remains controversial. We sought to evaluate the effects of the serum uric acid levels on major adverse cardiovascular events (MACEs) in the patients with coronary artery disease (CAD).
SUBJECTS AND METHODS
The study population consisted of 660 consecutive patients with CAD, and they were followed up for a mean of 27 months (maximum: 62 months). The recorded MACEs included acute myocardial infarction (AMI), stroke, coronary artery bypass graft, percutaneous coronary intervention (PCI) due to de novo lesion during follow up, congestive heart failure (CHF) and sudden cardiac death.
RESULTS
In the CAD patients with a uric acid level < or =3.88 mg/dL (the lowest quartile), as compared with those CAD patients with uric acid levels >5.74 mg/dL (the highest quartile), the MACE rate increased from 7.2% to 20.1%. On univariate Cox regression analysis, the highest uric acid quartile was a predictor of AMI, CHF and MACE. The absolute serum uric acid level was predictive of PCI, CHF and MACE. Multivariate Cox regression analysis showed that the independent predictors of MACE were presentation with acute coronary syndrome (HR 1.70, 95% CI: 1.04 to 2.78, p=0.033), multi-vessel disease (HR 2.43, 95% CI: 1.44 to 4.12, p=0.001), and the uric acid levels (HR 1.22, 95% CI: 1.05 to 1.43, p=0.010), and the highest uric acid quartile (HR 2.54, 95% CI: 1.58 to 4.10, p<0.001).
CONCLUSION
The serum uric acid level and multi-vessel disease are associated with subsequent cardiovascular events in the patients with CAD.

Keyword

Uric acid; Coronary artery disease; Prognosis
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