Elevated serum uric acid is an independent predictor for cardiovascular events in patients with severe coronary artery stenosis: subanalysis of the Japanese Coronary Artery Disease (JCAD) Study.
BACKGROUND
The association of elevated serum uric acid (UA) with cardiovascular events in patients with severe coronary artery stenosis was examined.


RESULTS
Patients with stenosis > or = 75% (n=8,832) were followed for "all events" (cardiovascular events and all-cause mortality) for 3 years. The group was divided into quartiles based on baseline UA level. The incidence rate of all events was significantly different among quartiles (58.3, 56.5, 61.2, 76.3/1,000 patients-year, P<0.001). Cox's proportional hazard regression analysis showed that the hazard ratio (HR) for all events was 1.25 [95% confidence interval (CI): 1.07-1.45, P<0.01] in the highest quartile (UA > or = 6.8 mg/dl). The group in which UA increased > or = 1.0 mg/dl after 6 months had significantly higher cardiovascular events rate than the group in which UA did not change (70.6 vs 58.8/1,000 patients-year, P=0.042). Propensity score matching was performed and 4,206 patients were divided into the highest quartile and the rest. High UA remained an independent predictor of all events (HR 1.25, 95%CI 1.06-1.43). However, no significant difference was observed between the group with increased UA > or = 1.0 mg/dl and the group with unchanged UA level.


CONCLUSIONS
Elevated UA is an independent predictor of cardiovascular events and all-cause mortality combined in patients with coronary artery stenosis.
Okura
Takafumi
T
Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Japan. okura@m.ehime-u.ac.jp
Higaki
Jitsuo
J
Kurata
Mie
M
Irita
Jun
J
Miyoshi
Ken-ichi
K
Yamazaki
Tsutomu
T
Hayashi
Doubun
D
Kohro
Takahide
T
Nagai
Ryozo
R