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

Abstract

Background: Serum uric acid (SUA) has been correlated with cardiac morbidity and mortality. However, its prognostic value in acute ST-segment elevation myocardial infarction (STEMI) is still uncertain. The aim of this study was to evaluate the prognostic value of SUA on admission in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI). Methods: We prospectively enrolled 150 STEMI patients underwent PPCI. The mean age of the studied population was 56.1 years, 78% were males while 22% were females. Patients were divided into tertiles based on the basal serum uric acid level. Patients with high SUA (n = 72) was defined as a value in the third tertile (>6.4 mg/dl), and a low SUA group (n = 78) was set as a value in the lower two tertiles (<6.4 mg/dl). Clinical characteristics, angiographic findings, echocardiographic data, in-hospital and three-month outcomes of PPCI were analyzed. Results: SUA level on admission carried prognostic value in patients with STEMI undergoing PPCI where the low uric acid group had better KILLIP class (P = 0.001), better TIMI flow (P = 0.001), higher ejection fraction (49.53 ± 8.75 versus 39.95 ± 7.06; P = 0.001), better survival and lower incidence of other major adverse cardiac events (MACE) (P = 0.01) during the hospital stay and three months follow up than the high uric acid group. Age, SUA > 6 mg/dl, TIMI flow, Killip class and EF < 40% were independent predictors for MACE in such patients. Conclusions: High SUA level on admission was associated with higher frequency of in-hospital and three months follow up MACE in patients with acute STEMI undergoing PPCI.