Does Serum Uric Acid Level Affect Coronary Collaterals in Patients With Acute Coronary Syndrome

Duran, Mustafa; Murat, Sani Namık; Örnek, Ender

doi:10.1177/0003319712463421

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…This metabolic pathway is source of production of oxygen-free radicals (3). Several recent studies supported the association between serum uric acid (SUA) and cardiovascular diseases (CVDs) (4-8). Increased SUA concentrations are associated with hypertension, atherogenic dyslipidemia, diabetes, age, alcohol consumption and renal failure.…”

Section: Introductionmentioning

confidence: 95%

Serum Uric Acid Could Differentiate Acute Myocardial Infarction and Unstable Angina Pectoris in Hyperuricemic Acute Coronary Syndrome Patients

Hasić¹,

Kadić²,

Kiseljaković³

et al. 2017

Med Arch

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Introduction:Serum uric acid (SUA) is the final product of purine metabolism in humans.Aim:The present study aimed to identify a potential association between serum UA and cardiac troponin I (cTnI) levels and to find out whether uric acid could differentiate patients presenting with the acute myocardial infarction (AMI) and unstable angina pectoris (UAP) in hyperuricemic and normouricemic acute coronary syndrome (ACS) patients.Methods:Eighty ACS patients, aged 50-83 years, were enrolled in the study, 40 of them presenting with AMI and 40 with UAP. Frequency of patients with serum uric level over threshold for hyperuricemia was investigated and two groups of patients were formed such as hyperuricemic and normouricemic groups (A and B groups, respectively) independently of type of ACS. Those groups of patients were also subjected to cTnI measurement.Results:Levels of SUA are associated with the type of ACS in the hyperuricemic ACS patients (AMI versus UAP, 499(458-590), 425(400-447) mmol/L, p=0.007, respectively). Uric acid correlated significantly with cTnI, moderate positively in the group A (rho=0.358, p=0.038) and moderate negatively in the group B (r=-0.309, p=0.037) of ACS patients. Multiple logistic regression analysis revealed that cTnI and age were independently associated with the SUA levels in the group A of ACS patients.Conclusions:Serum uric acid differentiates AIM and UAP patients in hyperuricemic group of acute coronary syndrome. Therefore it can be used as nonspecific parameter for evaluation of the myocardial lesion extent only in hyperuricemic ACS patients. This is supported by finding that cTnI along with age predicts SUA level in hyperuricemic ACS patients.

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Section: Introductionmentioning

confidence: 95%

Serum Uric Acid Could Differentiate Acute Myocardial Infarction and Unstable Angina Pectoris in Hyperuricemic Acute Coronary Syndrome Patients

Hasić¹,

Kadić²,

Kiseljaković³

et al. 2017

Med Arch

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“…3,4 High SUA levels are associated with poor CCC in patients with acute coronary syndrome (ACS). [5][6][7][8][9] To our knowledge, the relationship between SUA levels and development of CCC in patients with stable CAD has not been evaluated. Our aim was to investigate the association between SUA levels and the development of CCC in patients with stable CAD.…”

Section: Introductionmentioning

confidence: 99%

Association Between Uric Acid and Coronary Collateral Circulation in Patients With Stable Coronary Artery Disease

et al. 2013

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Serum uric acid (SUA) levels have been proposed as a biomarker of coronary artery disease (CAD) and coronary collateral circulation (CCC). We investigated the association between SUA levels and development of CCC in patients with stable CAD. Consecutive patients (n = 480) with stable CAD who underwent coronary angiography and documented total occlusion in 1 of the major coronary arteries were included in this study. Levels of fasting blood glucose, white blood cell (WBC), creatinine, platelet count, and SUA were significantly higher in patients with poor CCC than in those with good CCC. After multivariate analysis, high levels of SUA were an independent predictor of CCC together with levels of fasting blood glucose and WBC. The receiver-operating characteristic analysis provided a cutoff value of 5.65 mg/dL for SUA to predict poor CCC with 60% sensitivity and 66% specificity. High levels of SUA may be associated with poor CCC in patients with stable CAD.

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“…3,4 In contrast, there are several recent studies that supported the association between SUA and cardiovascular diseases (CVDs). [5][6][7][8][9][10][11][12][13] Kivity et al suggested that the association of SUA levels with CVD supported exploration of SUA as a risk marker of CVD in healthy populations. 9 Bickel et al showed a 5-fold increase in mortality in patients with uric acid >7.1 mg/dL versus those with SUA <5.1 mg/dL over a 2.2-year follow-up in patients with angiographically proven CAD.…”

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confidence: 99%

Uric Acid As a Cardiovascular Risk Factor Or Not?

et al. 2013

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We concluded that high levels of serum uric acid (SUA) were associated with poor coronary collateral circulation (CCC) in patients with stable coronary artery disease (CAD). 1 We thank Koza et al for their comments on our manuscript. 2 It is still unclear as to whether SUA is an independent predictor of CAD. The utility of SUA as a cardiovascular risk factor has not been approved in meta-analyses. 3,4 In contrast, there are several recent studies that supported the association between SUA and cardiovascular diseases (CVDs). [5][6][7][8][9][10][11][12][13] Kivity et al suggested that the association of SUA levels with CVD supported exploration of SUA as a risk marker of CVD in healthy populations. 9 Bickel et al showed a 5-fold increase in mortality in patients with uric acid >7.1 mg/dL versus those with SUA <5.1 mg/dL over a 2.2-year follow-up in patients with angiographically proven CAD. 10 In another study, SUA predicted an increased risk of cardiac and all-cause mortality independent of traditional cardiovascular risk factors, left ventricular function, C-reactive protein, and renal function across all subgroups of patients with CAD. 11 Furthermore, Lin et al found that high SUA levels were predictive of cardiac and all-cause mortality among patients with obstructive CAD defined by angiography in 1054 patients in a median followup of 3.1 years. 12 Additionally, Kaya et al found that high SUA levels on admission were independently associated with inhospital and long-term adverse outcomes in patients with STsegment elevation myocardial infarction who undergo primary percutaneous coronary intervention. 13 Several mechanisms that explain the relationship between SUA and CCC have been mentioned in our manuscript.Further prospective clinical studies are needed to determine the causal association and its exact physiopathologic process and whether lowering SUA can provide survival benefit in patients at risk of CAD or in patients with established CAD.

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Does Serum Uric Acid Level Affect Coronary Collaterals in Patients With Acute Coronary Syndrome

Cited by 4 publications

References 13 publications

Serum Uric Acid Could Differentiate Acute Myocardial Infarction and Unstable Angina Pectoris in Hyperuricemic Acute Coronary Syndrome Patients

Serum Uric Acid Could Differentiate Acute Myocardial Infarction and Unstable Angina Pectoris in Hyperuricemic Acute Coronary Syndrome Patients

Association Between Uric Acid and Coronary Collateral Circulation in Patients With Stable Coronary Artery Disease

Uric Acid As a Cardiovascular Risk Factor Or Not?

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