Hyperuricaemia and long‐term outcome after hospital discharge in acute heart failure patients

Abstract

Background: Uric acid (UA) may be involved in chronic heart failure (HF) pathogenesis, entailing a worse outcome. The purpose of this study was to examine the role of hyperuricaemia as a prognostic marker after hospital discharge in acute HF patients. Methods: We studied 212 patients consecutively discharged after an episode of acute HF with LVEF b 40%. Blood samples for UA measurement were extracted in the morning prior to discharge. The evaluated endpoints were death and new HF hospitalization. Results: Mean UA levels were 7.4 ± 2.4 mg/dl (range 1.6 to 16 mg/dl), with 127 (60%) of patients being within the range of hyperuricaemia. Hyperuricaemia was associated with a higher risk of death (n = 48) (HR 2.0, 95% CI 1.1-3.9, p = 0.028), new HF readmission (n = 67) (HR 1.8, 95% CI 1.1-3.1, p = 0.023) and the combined event (n = 100) (HR 1.9, 95% CI 1.2-2.9, p = 0.004). At 24 months, cumulative event-free survival was lower in the two higher UA quartiles (36.9% and 40.7% vs. 63.5% and 59.5%, log rank = 0.006). After adjustment for potential confounders, hyperuricaemia remains an independent risk factor for adverse outcomes (HR 1.6, 95% CI 1.1-2.6, p = 0.02). Conclusions: In hospitalized patients with acute HF and LV systolic dysfunction, hyperuricaemia is a long-term prognostic marker for death and/or new HF readmission.

Determinants and Prognostic Impact of Hyperuricemia in Hospitalization for Acute Heart Failure

“…20 Data regarding the prognostic value of uric acid in patients hospitalized for AHF, however, are contradictory. 8-10,21, 22 Pascual-Figal et al showed that uric acid was a prognostic marker in AHF patients with reduced LVEF during a mean follow-up of 2 years. 22 It seemed that there was a threshold Kaplan-Meier analysis indicated an increasing risk of death with quartile distribution of uric acid level, with cumulated survival rates of 62.2%, 61.0%, 55.1% and 48.2%, respectively, in a 4-year follow-up duration (Figure 1).…”

“…8-10,21, 22 Pascual-Figal et al showed that uric acid was a prognostic marker in AHF patients with reduced LVEF during a mean follow-up of 2 years. 22 It seemed that there was a threshold Kaplan-Meier analysis indicated an increasing risk of death with quartile distribution of uric acid level, with cumulated survival rates of 62.2%, 61.0%, 55.1% and 48.2%, respectively, in a 4-year follow-up duration (Figure 1). In addition, the associated risks of hyperuricemia were also statistically significant in patients with reduced and preserved LVEF (Figure 2).…”

“Medicine of the Whole Patient”: A Modern Perusal of Classical Clinician’s Text

“…Выделяют, по крайней мере, пять подтипов этих белков: предсердный натрийуретиче-ский пептид (Тип A), мозговой натрийуретический пептид (BNP, тип B) и типы C, D и V [25]. Наибольший интерес с патофизиологической точки зрения представ-долгосрочным прогностическим маркером смерти или повторной госпитализации [35].…”

Part Ii. Other Optimized Upstream Therapy for Managing Patients With Postinfarction Cardiosclerosis Associated With Hyperuricemia

“…OTHER DZIAŁ II. RÓŻNE marker for mortality in subjects with pre-existing heart failure [1,2,3,4,5,6]. According to the WHO experts' recommendations, hyperuricemia is considered to be a component of metabolic syndrome [7,8,9,10,11,12].…”