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Elevated serum uric acid levels following heart transplantation predict all‐cause and cardiac mortality
Author(s) -
Arora Satish,
Aukrust Pål,
Ueland Thor,
Broch Kaspar,
Simonsen Svein,
Gude Einar,
Fiane Arnt E.,
Geiran Odd,
Wergeland Ragnhild,
Andreassen Arne K.,
Gullestad Lars
Publication year - 2009
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfp115
Subject(s) - medicine , uric acid , pathophysiology , natriuretic peptide , cardiology , oxidative stress , heart failure , quartile , heart transplantation , inflammation , c reactive protein , gastroenterology , confidence interval
Aims We evaluated the relationship between elevated serum uric acid (SUA) and mortality as well as cardiac allograft vasculopathy (CAV) among 184 heart transplant (HTx) recipients. We also measured inflammatory, neurohormonal, and oxidative stress markers to explore pathophysiological mechanisms. Methods and results There were 28 (15%) deaths, patients with SUA ≥502 µmol/L (upper quartile) at 1 year post‐HTx had an increased risk of total mortality (adjusted HR 2.21, P = 0.03) and cardiac mortality (adjusted HR 4.38, P = 0.03). Elevated SUA was a significant risk factor for development of moderate/severe angiographic CAV (adjusted HR 4.79, P = 0.01). A smaller decline in SUA (<97 µmol/L) during the first year post‐HTx was also associated with an increased risk of mortality ( P = 0.02). Patients with elevated SUA had significantly higher levels of high‐sensitivity C‐reactive protein ( P = 0.008) and N‐terminal probrain natriuretic peptide ( P = 0.022), but there was no significant difference in oxidative stress parameters. Conclusion Elevated SUA at 1 year post‐HTx, or a modest rather than a marked decline in SUA levels during the first year post‐HTx, is associated with an increased risk of mortality. Although the pathophysiological mechanism is unclear, our data indicate a potential relationship between SUA and inflammation which should be explored further.