Uric acid in-hospital changes predict mortality in patients with acute myocardial infarction

作者：Lazaros G^*; Tsiachris D; Aznaouridis K; Vlachopoulos C; Tsioufis C; Chrysohoou C; Patialiakas A; Masoura C; Stefanadis C

来源：Nutrition Metabolism and Cardiovascular Diseases, 2013, 23(12): 1202-1209.

DOI：10.1016/j.numecd.2013.04.001

• Uric acid levels
• Acute myocardial infarction
• Risk stratification
• Mortality

Background and aims: The prognostic impact of admission uric acid (UA) levels in patients with acute myocardial infarction (AMI) is controversial. We assessed the prognostic role of in-hospital UA changes in patients with AMI. %26lt;br%26gt;Methods and results: We studied 375 consecutive patients (320 males, mean age 62.6 years) with AMI (232 with ST elevation MI) within 12 h of symptoms%26apos; onset. UA levels were daily measured throughout hospitalization and their admission and peak values were recorded. End-points were 30-day and 1-year mortality. Mortality rate at 30 days was 7.2% and at 1 year 10.9%. Patients who died within 30 days exhibited higher peak UA (10.24 mg/dl vs. 7.06 mg/dl, p %26lt; 0.001) and absolute UA elevation (1.7 mg/dl vs. 0.7 mg/dl, p %26lt; 0.001). Optimal values for predicting 30-day mortality were 9.65 mg/dl for peak UA and 2.35 mg/dl for UA elevation. Concerning 1-year mortality, deceased patients had higher peak UA levels (9.71 mg/dl vs. 7 mg/dl, p %26lt; 0.001) and absolute UA elevation (1.5 mg/dl vs. 0.6 mg/dl, p %26lt; 0.001). Optimal values for predicting 1-year mortality were 9.55 mg/dl for peak UA and 1.1 mg/dl for UA elevation. With Cox regression analysis peak UA (adjHR 1.157, p = 0.030) and UA elevation (adjHR 1.288, p = 0.009) were independent predictors of 30-day mortality. Similarly, peak UA levels (adjHR 1.204, p = 0.001) and UA elevation (adjHR 1.213, p = 0.001) predicted 1-year mortality. %26lt;br%26gt;Conclusions: In patients with AMI peak rather than admission UA levels, and absolute in-hospital UA elevation predict both 30-day and 1-year mortality. Serial in-hospital UA measurements add prognostic information in AMI patients.

• 出版日期2013-12