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open access

Ahead of print
Original Article
Submitted: 2021-07-12
Accepted: 2021-08-13
Published online: 2021-12-01
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Serum uric acid is an independent risk factor of worse mid- and long-term outcomes in patients with non-ST-segment elevation acute coronary syndromes

Maciej Dyrbuś1, Piotr Desperak2, Marta Pawełek1, Mateusz Możdżeń1, Mariusz Gąsior2, Michał Hawranek2
DOI: 10.5603/CJ.a2021.0156
·
Pubmed: 34897641
Affiliations
  1. Student Scientific Society, 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
  2. 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

open access

Ahead of print
Original articles
Submitted: 2021-07-12
Accepted: 2021-08-13
Published online: 2021-12-01

Abstract

Background: The data on the association between serum uric acid (sUA) concentration and outcomes in patients with an ACS are inconsistent and do not focus on patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). The aim of this study was to analyze an association of sUA concentration on admission and outcomes in those patients. Methods: Data from the prospective, single-center registry of patients hospitalized due to NSTE-ACS from January 2006 to December 2016 were analyzed retrospectively. The population was divided into quartiles according to the baseline sUA. The primary outcome was the incidence of all-cause death, non-fatal myocardial infarction, stroke and ACS-driven revascularization at 36 months. Results: Total of 2,824 patients with sUA measured on admission were included in this analysis with a median sUA of 352 µmol/L (5.92 mg/dL). Patients with higher sUA were older and more burdened with cardiovascular risk factors and history of coronary events. The prevalence of multivessel coronary artery disease and left main stenosis was significantly higher in patients with higher sUA. Elevated sUA concentration was associated with significantly worse short-, mid- and long-term outcomes. All-cause mortality was significantly higher in each analyzed period. In the multivariable analysis, sUA elevation was identified as an independent predictor of all-cause mortality at 12-month and 36-month follow-up. Conclusions: Elevated baseline sUA concentration was independently associated with worse mid- and long-term outcomes in patients with NSTE-ACS. Baseline sUA concentration could identify patients with NSTE-ACS at higher risk of more dismal prognosis.

Abstract

Background: The data on the association between serum uric acid (sUA) concentration and outcomes in patients with an ACS are inconsistent and do not focus on patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). The aim of this study was to analyze an association of sUA concentration on admission and outcomes in those patients. Methods: Data from the prospective, single-center registry of patients hospitalized due to NSTE-ACS from January 2006 to December 2016 were analyzed retrospectively. The population was divided into quartiles according to the baseline sUA. The primary outcome was the incidence of all-cause death, non-fatal myocardial infarction, stroke and ACS-driven revascularization at 36 months. Results: Total of 2,824 patients with sUA measured on admission were included in this analysis with a median sUA of 352 µmol/L (5.92 mg/dL). Patients with higher sUA were older and more burdened with cardiovascular risk factors and history of coronary events. The prevalence of multivessel coronary artery disease and left main stenosis was significantly higher in patients with higher sUA. Elevated sUA concentration was associated with significantly worse short-, mid- and long-term outcomes. All-cause mortality was significantly higher in each analyzed period. In the multivariable analysis, sUA elevation was identified as an independent predictor of all-cause mortality at 12-month and 36-month follow-up. Conclusions: Elevated baseline sUA concentration was independently associated with worse mid- and long-term outcomes in patients with NSTE-ACS. Baseline sUA concentration could identify patients with NSTE-ACS at higher risk of more dismal prognosis.

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Keywords

acute coronary syndrome, coronary angiography, mortality, revascularization; uric acid

Supp./Additional Files (2)
Supplementary Figure 1. Multivariable analysis of independent predictors of 12-month mortality.
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Supplementary Table 1. Comparison of baseline, angiographic and procedural characteristics, along with outcomes of the overall studied population dependent on the serum uric acid measurement performed on admission
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About this article
Title

Serum uric acid is an independent risk factor of worse mid- and long-term outcomes in patients with non-ST-segment elevation acute coronary syndromes

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2021-12-01

Page views

1382

Article views/downloads

463

DOI

10.5603/CJ.a2021.0156

Pubmed

34897641

Keywords

acute coronary syndrome
coronary angiography
mortality
revascularization
uric acid

Authors

Maciej Dyrbuś
Piotr Desperak
Marta Pawełek
Mateusz Możdżeń
Mariusz Gąsior
Michał Hawranek

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