Prognostic significance of hyperuricemia in patients with different types of renal dysfunction and acute myocardial infarction treated with percutaneous coronary intervention.
OBJECTIVE
This study evaluated the impact of hyperuricemia (HUR) on outcome in patients with different types of impaired renal function (IRF) and acute myocardial infarction (AMI) treated invasively.


METHODS
Out of 3,593 consecutive AMI patients treated invasively, 1,015 IRF patients were selected. The IRF group consisted of patients with baseline kidney dysfunction (BKD group) and/or patients with contrast-induced nephropathy (CIN group). HUR was defined as a serum uric acid concentration (SUAC) >420 μmol/l (>7 mg/dl). Independent predictors of death and major adverse cardiovascular events (MACE) were selected by the multivariate Cox-regression model.


RESULTS
Remote mortality rates were higher in HUR patients: IRF (32.7 vs. 18.6%), BKD (41.3 vs. 25.9%), CIN (35.4 vs. 16.7%); all p < 0.001. HUR was an independent predictor of death in BKD (hazard ratio (HR) 1.38, p < 0.05). Each 100-μmol/l increase in SUAC was associated with a significant increase of HR for mortality: 1.087 in IRF patients, 1.108 in BKD patients, 1.128 in CIN patients; all p < 0.05. Remote major adverse cardiovascular event rates were higher in HUR patients: IRF (55.4 vs. 48.9%), CIN (56.8 vs. 48%); both p < 0.05.


CONCLUSIONS
In AMI patients treated invasively, an increase in SUAC is an independent predictor of death within all types of renal dysfunction; HUR defined as SUAC >420 μmol/l (>7 mg/dl) is a predictor only in BKD patients.
Kowalczyk
Jacek
J
Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland. jacekmed@yahoo.com
Francuz
Pawel
P
Swoboda
Ryszard
R
Lenarczyk
Radoslaw
R
Sredniawa
Beata
B
Golda
Adam
A
Kurek
Tomasz
T
Mazurek
Michal
M
Podolecki
Tomasz
T
Polonski
Lech
L
Kalarus
Zbigniew
Z
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016208:Databases, Factual / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D033461:Hyperuricemia / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D051437:Renal Insufficiency / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome