Uric Acid Level as a Predictor of Long-Term Mortality in Advanced Age Population

Sneineh, Marwan Abu; Schwartz, Y.; Nesher, Gideon; Dror, Yossi Freier; Breuer, Gabriel S.

doi:10.1016/j.amjms.2019.10.017

Cited by 10 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the Cardiovascular Study in the Elderly (CASTEL), SUA was independently associated with coronary mortality in diabetic older patients [ 17 ]. Finally, in recent studies SUA predicted in-hospital and long-term all-cause mortality in older hospitalized patients [ 18 , 28 ]. By contrast, other authors do not confirm these associations, implying that the prognostic relevance of SUA does not apply to older individuals [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

The association of uric acid with mortality modifies at old age: data from the uric acid right for heart health (URRAH) study

Ungar

Rivasi

Bari

et al. 2021

Journal of Hypertension

View full text Add to dashboard Cite

Objectives:In older individuals, the role of serum uric acid (SUA) as risk factor for mortality is debated. This study investigated the association of SUA with all-cause and cardiovascular (CV) mortality in older adults participating in the large multicentre observational uric acid right for heart health (URRAH) study.Methods:Eight thousand URRAH participants aged 65+ were included in the analysis. The predictive role of SUA was assessed using Cox regression models stratified according to the cut-off age of 75. SUA was tested as continuous and categorical variable (age-specific quartiles). The prognostic threshold of SUA for mortality was analysed using receiver operating characteristic curves.Results:Among participants aged 65–74, multivariate Cox regression analysis adjusted for CV risk factors and comorbidities identified an independent association of SUA with both all-cause mortality (hazard ratio [HR] 1.169, 95% confidence interval [CI] 1.107–1.235) and CV mortality (HR 1.146, 95% CI 1.064–1.235). The cut-off value of 4.8 mg/dl discriminated mortality status. In participants aged 75+, we observed a J-shaped relationship of SUA with all-cause and CV mortality, with risk increasing at extreme SUA levels.Conclusions:These results confirmed the predictive role of SUA for all-cause and CV mortality in older adults, while revealing considerable age-related differences. Mortality risk increased at higher SUA levels in participants aged 65–74, with a prognostic threshold of 4.8 mg/dl. The relationship between SUA and mortality was J-shaped in oldest participants. Large interventional studies are needed to clarify the benefits and possible risks of urate-lowering treatments in older adults.

show abstract

Section: Discussionmentioning

confidence: 99%

The association of uric acid with mortality modifies at old age: data from the uric acid right for heart health (URRAH) study

Ungar

Rivasi

Bari

et al. 2021

Journal of Hypertension

View full text Add to dashboard Cite

show abstract

“…Reduced renal excretion and diuretic therapy can also lead to elevated levels of UA 9,10 . Numerous recent studies have established a close association between uric acid and the incidence and progression of heart failure 11–13 . This prompts questions regarding whether higher serum uric acid levels indicate a dysregulated pathway in the context of heart failure and whether lowering uric acid through treatment can improve adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

“… 9 , 10 Numerous recent studies have established a close association between uric acid and the incidence and progression of heart failure. 11 , 12 , 13 This prompts questions regarding whether higher serum uric acid levels indicate a dysregulated pathway in the context of heart failure and whether lowering uric acid through treatment can improve adverse outcomes. The effectiveness of uric acid‐lowering treatment on heart failure outcomes remains controversial, with some studies suggesting its potential to improve adverse outcomes, 14 , 15 , 16 while others indicate no significant improvement in patient survival.…”

Section: Introductionmentioning

confidence: 99%

Uric acid is a biomarker for heart failure, but not therapeutic target: result from a comprehensive meta‐analysis

Qin,

Xiang,

Gao

et al. 2023

ESC Heart Failure

View full text Add to dashboard Cite

AimsThis systematic review and meta‐analysis aimed to investigate the association between serum uric acid (SUA) levels and the incidence rate and prognosis of heart failure (HF), as well as the impact of uric acid‐lowering treatment on HF patients.Methods and resultsPubMed and Embase were searched for original articles reporting on the association between SUA and HF incidence, adverse outcomes, and the effect of uric acid‐lowering treatment in HF patients. Data were pooled using random effects or fixed effects models. Univariable meta‐regression analysis assessed the influence of study characteristics on research outcomes. Statistical analyses were conducted using RevMan software and STATA software version 15.0. Eleven studies on HF incidence and 24 studies on adverse outcomes in HF patients were included. Higher SUA levels were associated with an increased risk of HF (RR: 1.81, 95% CI: 1.53–2.16), all‐cause mortality (RR: 1.44, 95% CI: 1.25–1.66), cardiac death (RR: 1.56, 95% CI: 1.32–1.84), and HF rehospitalization (RR: 2.07, 95% CI: 1.37–3.13) in HF patients. Uric acid‐lowering treatment was found to increase all‐cause mortality in HF patients (RR: 1.15, 95% CI: 1.05–1.25).ConclusionsUric acid is an independent predictor of heart failure occurrence and adverse prognosis. Targeting uric acid lowering as a therapeutic intervention does not improve the prognosis of patients with heart failure. It may not be advisable to use traditional urate‐lowering drugs in young patients with heart failure, and elderly patients should exercise caution when using them.

show abstract

“…There are many factors that affect the survival rate of patients receiving dialysis treatment, including residual renal function, serum uric acid (SUA), and so on [ 7 ]. Uric acid (UA) is the final product in the liver from the degradation of dietary and endogenously synthesized purine or nucleotide compounds [ 8 ], about two-thirds of which is excreted by glomerular filtration [ 9 ]. Studies have found that UA is closely related to many chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

Serum uric acid level and all-cause and cardiovascular mortality in peritoneal dialysis patients: A systematic review and dose-response meta-analysis of cohort studies

Kang

Huang

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Background The association between serum uric acid (SUA) and all-cause and cardiovascular disease (CVD) mortality in peritoneal dialysis (PD) patients is controversial. Therefore, we aimed to determine the relationship between SUA and all-cause and CVD mortality in PD patients. Method Web of Science, EMBASE, PubMed and the Cochrane Library databases were searched from their inception to 7 April 2021. Effect estimates were presented as hazard ratios (HRs) with 95% confidence intervals (95% CIs) and pooled using random effects model. Result Thirteen cohort studies with 22418 patients were included in this systematic review, of which 9 were included in the meta-analysis. Before switching the reference group, pooled result for the highest SUA category was significantly greater than the median for all-cause mortality (HR = 2.41, 95% CI: 1.37–4.26). After switching the reference group, the highest SUA category did not demonstrate an increased all-cause (HR = 1.40, 95% CI: 0.95–2.05) or CVD (HR = 1.30, 95% CI: 0.72–2.34) mortality compared with the lowest SUA category. Dose-response analysis suggested a nonlinear association between SUA and all-cause mortality risk (Pnonlinearity = 0.002). Conclusion This meta-analysis didn’t find the relationship between SUA levels and all-cause and CVD mortality risk in PD patients. More rigorously designed studies are warranted in the future.

show abstract

Uric Acid Level as a Predictor of Long-Term Mortality in Advanced Age Population

Cited by 10 publications

References 14 publications

The association of uric acid with mortality modifies at old age: data from the uric acid right for heart health (URRAH) study

The association of uric acid with mortality modifies at old age: data from the uric acid right for heart health (URRAH) study

Uric acid is a biomarker for heart failure, but not therapeutic target: result from a comprehensive meta‐analysis

Serum uric acid level and all-cause and cardiovascular mortality in peritoneal dialysis patients: A systematic review and dose-response meta-analysis of cohort studies

Contact Info

Product

Resources

About