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

Abstract

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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“…The mean age of Burki L et al 14 study was found to be 50.0±12.4, this was similar with our study. While higher mean age of 61 yearsand 62.6 was seen with Forman JPet al 15 and Hajizadeh R et al 16 In our study we did not find any significance between serum uric acid and glycemic control in infarction cases. Cirakli ZL et al 17 and Biswas K et al 18 also concluded the same.…”

Serum uric acid was an independent predictor of mortality in ST-segment elevation myocardial infarction patients with Killip I other than Killip II-IV Comment on "J Cardiovasc Thorac Res 2016;8:56-60"

“… 2 - 6 The conflicting results could be explained by that heart failure severity as a complication of the STEMI patients, namely Killip’s classification, were as lower as approximately 20% in the Hajizadeh et al’s study than in other studies that mainly consisted of STEMI patients with Killip I undergoing primary PCI. 1 - 6 In the PCI era, a higher value of SUA on admission was significantly associated with increased short- and long-term mortality in these studies. 5 In our study, we could not either show a significant association between hyperuricemia and mortality in STEMI patients at Killip II-IV, but there was a significant association in the patients with Killip II-IV between hyperuricemia and 1-year mortality.…”

“…We read with much interest in Hajizadeh et al’s article that was recently published in the Journal of Cardiovascular and Thoracic Research . 1 Hajizadeh et al enrolled acute STEMI patients undergoing thrombolytic therapies or primary percutaneous coronary interventions (PCIs); the higher SUA group was defined as a baseline value of SUA more than 8.0 mg/dL in male or 7.5 mg/dL in female, and Hajizadeh et al showed that a higher value of SUA was not associated with in-hospital and midterm mortality. However, several issues should be addressed.…”

Prognostic Value of Serum Uric Acid Level in Patients with ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

“…In this study the High SUA level was defined as more than 8 mg/dL in men and more than 7.5 mg/dL in women which is much more than the cutoff point for hyperuricemia in most literatures. It also included a generally older population than our population as the mean age for all population in the study, in years, was 62.6 ± 13.4 SD versus 56.10 ± 11.17 in our study, and that is expected to increase the mortality in all groups without discrimination [20].…”