Hyperuricemia in acute heart failure. More than a simple spectator?
BACKGROUND
Hyperuricemia is a prevalent condition in chronic heart failure (CHF), describing increased oxidative stress and inflammation. Although there is evidence that serum uric acid (UA) predicts mortality in CHF, its role as a prognostic biomarker in acute heart failure (AHF) has not yet been well assessed. The aim of this study was to determine if UA levels predict all-cause mortality. Additionally, as a secondary endpoint we sought the clinical predictors of UA serum level in this population.


METHODS
We analyzed 560 consecutive patients with AHF admitted in a single university center. UA (mg/dl) was measured during early hospitalization. Patient survival status was followed up after discharge (median follow-up: 330 days). The independent association of UA level with all-cause mortality was analyzed using Cox regression analysis.


RESULTS
During follow-up 165 (29.5%) deaths were identified. Patients with UA levels above the median value (>or=7.7 mg/dl) exhibited higher mortality rates (21.1 vs. 37.9%; p<0.001). In multivariable analysis, after adjusting for recognized prognostic factors and potential confounders, UA>or=7.7 mg/dl and per change in 1 mg/dl of UA was associated with an increased risk of mortality (HR 1.45, CI 95%=1.03-2.44; p=0.03 and HR 1.08, CI 95%=1.01-1.15; p=0.03, respectively).


CONCLUSIONS
UA serum levels is an independent predictor of all-cause mortality in an unselected patients admitted with AHF.
Alimonda
Anna L
AL
Servicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain.
Núñez
Julio
J
Núñez
Eduardo
E
Husser
Oliver
O
Sanchis
Juan
J
Bodí
Vicent
V
Miñana
Gema
G
Robles
Rocio
R
Mainar
Luis
L
Merlos
Pilar
P
Darmofal
Helene
H
Llácer
Angel
A
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D006801:Humans; D033461:Hyperuricemia / Q000097:blood* / Q000401:mortality*; D008297:Male; D015999:Multivariate Analysis; D018384:Oxidative Stress; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D014527:Uric Acid / Q000097:blood*
D014527:Uric Acid