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Uric acid and prognosis in angiography‐proven coronary artery disease
Author(s) -
Ndrepepa Gjin,
Braun Siegmund,
King Lamin,
Fusaro Massimiliano,
Tada Tomohisa,
Cassese Salvatore,
Hadamitzky Martin,
Haase HansUllrich,
Schömig Albert,
Kastrati Adnan
Publication year - 2013
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12039
Subject(s) - medicine , hazard ratio , coronary artery disease , confidence interval , cardiology , uric acid , receiver operating characteristic
Background The optimal uric acid ( UA ) level associated with the lowest mortality and the strength of association between UA and mortality in various subgroups of patients with coronary artery disease ( CAD ) are unknown. Materials and methods This study included 13 273 patients with angiographic confirmation of CAD and UA measurements available. The primary outcome analysis was 1‐year mortality. Results Based on the receiver operating characteristic curve analysis, the best cut‐off of UA for mortality prediction was 7·11 mg/dL. Using this cut‐off, patients were divided into two groups: the group with UA ≤ 7·11 mg/dL ( n = 9075) and the group with UA > 7·11 mg/dL ( n = 4198). Cardiac mortality was 6·3% (256 deaths) in patients with UA > 7·11 mg/dL and 2·3% (201 deaths) in patients with UA ≤ 7·11 mg/dL [hazard ratio ( HR ) = 2·82, 95% confidence interval ( CI ) 2·36–3·36; P < 0·001]. After adjustment for cardiovascular risk factors, UA remained an independent correlate of cardiac mortality ( HR = 1·20, 95% CI 1·08–1·34; P = 0·001, for each standard deviation increase in the logarithmic scale of UA ). The relationship between cardiac or all‐cause mortality and UA showed a J‐shaped pattern with lowest mortality in patients with UA between 5·17 and 6·76 mg/dL. UA predicted mortality across all subgroups of patients, with strongest association in women and patients without arterial hypertension. Conclusions UA predicted an increased risk of cardiac mortality across all subgroups of patients with CAD . The association between UA and cardiac or all‐cause mortality had a ‘J‐shaped’ pattern with lowest risk of death in patients with UA levels between 5·17 and < 6·76 mg/dL.