Hyperuricaemia and long-term outcome after hospital discharge in acute heart failure patients.
BACKGROUND
Uric acid (UA) may be involved in chronic heart failure (HF) pathogenesis, entailing a worse outcome. The purpose of this study was to examine the role of hyperuricaemia as a prognostic marker after hospital discharge in acute HF patients.


METHODS
We studied 212 patients consecutively discharged after an episode of acute HF with LVEF<40%. Blood samples for UA measurement were extracted in the morning prior to discharge. The evaluated endpoints were death and new HF hospitalization.


RESULTS
Mean UA levels were 7.4+/-2.4 mg/dl (range 1.6 to 16 mg/dl), with 127 (60%) of patients being within the range of hyperuricaemia. Hyperuricaemia was associated with a higher risk of death (n=48) (HR 2.0, 95% CI 1.1-3.9, p=0.028), new HF readmission (n=67) (HR 1.8, 95% CI 1.1-3.1, p=0.023) and the combined event (n=100) (HR 1.9, 95% CI 1.2-2.9, p=0.004). At 24 months, cumulative event-free survival was lower in the two higher UA quartiles (36.9% and 40.7% vs. 63.5% and 59.5%, log rank=0.006). After adjustment for potential confounders, hyperuricaemia remains an independent risk factor for adverse outcomes (HR 1.6, 95% CI 1.1-2.6, p=0.02).


CONCLUSIONS
In hospitalized patients with acute HF and LV systolic dysfunction, hyperuricaemia is a long-term prognostic marker for death and/or new HF readmission.
Pascual-Figal
Domingo A
DA
Cardiology Department, University Hospital Virgen de la Arrixaca, University of Murcia, Spain. dapascual@servicam.com
Hurtado-Martínez
Jose A
JA
Redondo
Belen
B
Antolinos
Maria J
MJ
Ruiperez
Juan A
JA
Valdes
Mariano
M
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D006801:Humans; D033461:Hyperuricemia / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission; D011379:Prognosis; D016016:Proportional Hazards Models; D012107:Research Design; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014527:Uric Acid / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000453:epidemiology / Q000209:etiology
D015415:Biomarkers; D014527:Uric Acid