Association of Uric Acid and C-reactive Protein with the Severity of Coronary Artery Disease Using SYNTAX Score and Clinical SYNTAX Score

Abstract

<jats:p>Background: The SYNTAX score (SXscore), an anatomical-based scoring tool reflecting the complexity of coronary anatomy, has been associated with the mortality and prognosis of coronary artery disease (CAD). Clinical SYNTAX score (CSS), incorporating clinical factors further augmented the utility of the SXscore to longer-term risk. C-reactive protein (CRP) is related to SXscore. Serum uric acid (UA) is associated with atherosclerosis and CAD. However, serum uric acid combined with CRP may better predict the SXscore and CSS.&#x0D; Methods: A total of 208 patients (mean age 57.82 ± 9.39 years) with chest pain were included in this study. All selected subjects underwent coronary artery angiography and blood test. The relationship between serum UA, CRP and SXscore, and CSS were analyzed.&#x0D; Results: Age and CRP had a positive correlation with SXs and CSS. DM and fasting glucose correlated with SXscore and CSS respectively. In multivariate regression, serum UA, age, fasting glucose, and body mass index (BMI) were significant discriminant factors of high CSS. The predictive accuracy of CRP for SXscore &gt;0 and high CSS using receiver operator characteristic curves was set at the cut off point of 0.205 mg/dL and 0.145 mg/dL respectively, (sensitivity 70.9% and 98%, specialty 48% and 23.2%).&#x0D; Conclusion: Serum CRP is correlated with SXscore and CSS, serum UA is independently associated with CSS. CRP predicts high CSS at a lower level than it predicts SXscore. Thus, serum CRP combined with serum UA may be useful to predict SXscore and CSS.</jats:p>

Uric Acid-to-Albumin Ratio: A Novel Marker for the Extent of Coronary Artery Disease in Patients with Non-ST-Elevated Myocardial Infarction

“…Epidemiological evidence suggests that hyperuricemia and cardiovascular disease are highly related [21]; increased UA levels are a statistically significant and independent predictor of cardiovascular disease and cardio-vascular mortality [22]. In a recent study the serum UA level was related to the severity of CAD and it was an independent predictor of a high SS [12]. However, the causal mechanisms linking elevated UA levels to cardiovascular disease are still not fully clear.…”

“…Primarily, UA levels are affected by a multitude of different factors, including renal excretion, the dietary intake of various foods, and the rate of uric acid cell turnover [13]. Additionally abnormally high levels of UA are often associated with gout, insulin resistance, DM, metabolic syndrome, HT, and chronic renal disease [12]. SA synthesis is increased by amino acids intake, insulin, and a low colloid osmotic pressure.…”

“…Factors that decrease synthesis include a high colloid osmotic pressure, inflammation, malnutrition, diabetes, liver disease, and infections, and the mechanisms of its degradation are poorly understood [14]. Common conditions in ill patients, such as malnutrition, infections, inflammation, congestive heart failure, and renal diseases, can affect the levels of UA and SA [31]; they might be involved in different phases of vascular damage [12]. As a result of this knowledge, we decided to assay UAR to increase each variable's separate predictive value and compare them to other previously proven inflammatory markers of CAD, CAR, and NLR.…”

“…UA is shown to be one of the mediators of endothelial dysfunction, inflammation, and vascular disease [11]. Hyperuricemia is connected to the higher burden of coronary atherosclerosis [12].…”

<p>The Association of Syntax Score with Levels of Lipoprotein(a) and Inflammatory Biomarkers in Patients with Stable Coronary Artery Disease and Different Low-Density Lipoprotein Cholesterol Levels</p>

“…The hsCRP level has been reported to be associated with Syntax score. [25][26][27] MHR was initially discovered to be associated with cardiovascular outcomes and was identified as an independent predictor of major adverse cardiovascular events in patients with chronic kidney disease. 28 The positive correlation of MHR with Syntax score in patients with stable CAD has been identified in several studies.…”