title: Serum uric Acid as a prognostic predictor in pulmonary arterial hypertension with connective tissue disease.
abstract: BACKGROUND
  Pulmonary arterial hypertension (PAH) has been identified as a life threatening complication of connective tissue disease. However, the association between serum uric acid (UA) levels and long-term outcome in PAH with connective tissue disease has not been evaluated. We therefore assessed whether serum UA levels are related to the mortality of such patients.
  
  
  RESULTS
  We investigated 90 consecutive patients with connective tissue disease who were initially diagnosed with PAH by echocardiography, and assessed the long-term clinical outcome in populations with higher (> or = 4.7 mg/dL) and lower serum UA levels. Kaplan-Meier analysis showed that patients with higher median serum UA values had a significantly worse survival rate for any cause of death (54.5% versus 84.7%, log-rank, P < 0.01) and PAH-related death (72.7% versus 93.4%, log-rank, P < 0.01) than those with low values. Multivariate analysis showed that an elevated serum UA level was an independent predictor for survival (hazard ratio, 1.88, 95% CI [1.24- 2.84], P < 0.01).
  
  
  CONCLUSIONS
  Elevated serum UA levels are associated with a poor prognosis and can serve as a prognostic predictor for patients with PAH secondary to connective tissue disease.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Widi
authors.initials: W
authors.lastname: Njaman
authors.forename: Takafumi
authors.initials: T
authors.lastname: Iesaki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Iwama
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Takasaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D015415:Biomarkers / Q000097:blood*; D003240:Connective Tissue Diseases / Q000150:complications* / Q000175:diagnosis; D004452:Echocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000209:etiology / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D014527:Uric Acid / Q000097:blood*