Relation of Serum Uric Acid Levels and Outcomes Among Patients Hospitalized for Worsening Heart Failure With Reduced Ejection Fraction (from the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan Trial)

Uric Acid, Oxidative Stress and Inflammation in Chronic Heart Failure with Reduced Ejection Fraction

“…The significant relationship in between sUA and LVEF found in the present study (r = -0.24, p=0.048) has also been demonstrated in several CHF studies (24,27,28). sUA level was related to NT-proBNP levels (24,26). Our data was similar to OPT-CHF trial results (29).…”

“…Large cohort studies demonstrated that hyperuricemia is a prognostic marker for poor outcomes for all cause mortality and CHF hospitalizations only in CHF patients without chronic kidney disease (6,21). In a recent meta-analysis of thirty-three studies assessing the relation between sUA and heart failure, the incremental elevation in sUA, by 1 mg/dL, increased risk of all cause mortality by 4% in patients with existing CHF and the odds of incident HF by 19% in the general population (26,30).…”

“…In CHF with normal kidney function, hyperuricemia is a consequence of increased production rather than reduced renal clearance (6,26). sUA is a marker of xanthine-oxidase up-regulation, triggered by local tissue ischemia or hypoxia, and generating free radicals proportionally to uric acid synthesis (12).…”

Allopurinol, is the Next General Drug for Chronic Heart Failure? A Review Based on 19 Clinical Trials

“…Moreover, in 2012 Israel et al demonstrated that increased UA levels and an increase in UA during follow-up were independent predictors of increased morbidity and mortality in patients with CHF [25]. And a newly published study suggested that serum UA level was commonly elevated in patients hospitalized for worsening chronic heart failure and reduced ejection fraction, especially in men and blacks [26]. Furthermore, a double-blind placebo-controlled crossover preliminary study especially suggested that it was upregulated XO activity rather than UA itself that actively involved in hemodynamic impairment in CHF [27].…”

Serum uric acid as a metabolic regulator of endothelial reparative processes in heart failure patients

“…acute coronary syndrome, acute and chronic cardiac failure, type 2 diabetes mellitus, atherosclerosis, the metabolic syndrome, chronic kidney disease, and obstructive sleep apnea syndrome [11][12][13][14][15] . However, the innate molecular mechanisms regarding effect of SUA on cardiovascular remodeling and as result in CHF development are still not clear and current clinical evidences on SUA in nature progression of cardiac failure are controversial.…”