Serum Uric Acid for Risk Stratification of Patients with Coronary Artery Disease

Vol. 114, No. 4, 2009

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Original Research

Serum Uric Acid for Risk Stratification of Patients with Coronary Artery Disease
Yafim Brodov^a, Pierre Chouraqui^{a, c}, Ilan Goldenberg^a, Valentina Boyko^b, Lori Mandelzweig^b, Shlomo Behar^{b, c}

^aHeart Institute and
^bNeufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer, and
^cSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

Address of Corresponding Author

Cardiology 2009;114:300-305 (DOI: 10.1159/000239860)

Key Words

Serum uric acid
Coronary artery disease
Primary end point risk

Abstract

Objectives: In patients with coronary artery disease (CAD), elevated serum uric acid (SUA) levels may predict worse cardiovascular outcomes. It is known that SUA levels are influenced by renal function. We aimed to assess the predictive value of SUA while taking into account patients' renal function. Methods: The primary end point (PEP) risk, including fatal or nonfatal myocardial infarction (MI) or sudden death, was assessed by SUA quintiles before and after adjustment for the estimated glomerular filtration rate (eGFR) in 2,796 nondiabetic CAD patients enrolled in the Bezafibrate Infarction Prevention study. Results: The PEP risk increased from the lowest (11.8%) to highest SUA quintile (18.0%), p < 0.005, respectively. After adjustment for age, sex, smoking, prior MI, metabolic syndrome variables, NYHA classes II-IV, heart rate and treatment with bezafibrate, diuretics, angiotensin-converting enzyme inhibitors, beta -blockers, calcium channel blockers and antiplatelets, the highest SUA quintile exhibited the highest PEP risk [hazard ratio (HR): 1.47 (95% CI: 1.06-2.04)]. Patients in the highest - compared with those in the lowest - quintiles continued to demonstrate an increased PEP risk [HR: 1.46 (95% CI: 1.04-2.06)], even after additional adjustment for the eGFR. Conclusion: In nondiabetic patients with CAD, elevated SUA levels are associated with an increased risk of cardiac events, independent of renal function.

Author Contacts

Yafim Brodov, MD
Heart Institute, Sheba Medical Center
Tel Hashomer 52621 (Israel)
Tel. +972 3 530 2604, Fax +972 3 534 3888
E-Mail brodov_y@bezeqint.net

Article Information

Received: January 20, 2009
Accepted after revision: May 27, 2009
Published online: September 23, 2009
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 4, Number of References : 41

Medline Abstract (ID 19776568)

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