title: Uric acid is predictive of cardiovascular mortality and sudden cardiac death in subjects referred for coronary angiography.
abstract: OBJECTIVE
  High serum uric acid (SUA) is suggested to be causally involved in the pathogenesis of vascular disease. The present study aimed to investigate whether SUA independently predicts all-cause mortality, cardiovascular mortality and sudden cardiac death in subjects scheduled for coronary angiography.
  
  
  RESULTS
  We studied participants of the LUdwigshafen RIsk and Cardiovascular health (LURIC) study. A total of 3245 individuals were included in the analysis. There was a follow-up for all-cause mortality, cardiovascular mortality, and sudden cardiac death with a mean (±standard deviation) duration of 7.3 (±2.3) years. Sex-specific quartiles of SUA were established and multivariate statistical models were used. A total of 730 deaths occurred during the follow-up. Among these, 473 (64.8%) were accounted for by cardiovascular diseases. Sudden cardiac death occurred in 184 (25.2%) cases. Adjusting for sex and age subjects in the fourth SUA quartile had increased all-cause (hazard ratio (HR) = 1.68, p < 0.001) and cardiovascular (HR = 2.00, p < 0.001) mortality compared to individuals in the first quartile. Furthermore, high SUA was a risk factor for sudden cardiac death (HR = 2.27, p < 0.001). These associations remained significant including cardiovascular risk factors and the severity of coronary atherosclerosis as covariates in the models. After additional adjustment for medication use statistical significance for the association between the SUA quartiles and all-cause mortality disappeared.
  
  
  CONCLUSIONS
  High SUA independently indicates increased risk for cardiovascular and sudden cardiac death in subjects referred for coronary angiography.
authors.affiliation: Division of Endocrinology, Diabetology, Nephrology, Vascular Disease, and Clinical Chemistry, Department of Internal Medicine, Eberhard-Karls-University Tübingen, Tübingen, Germany. guenther.silbernagel@med.uni-tuebingen.de
authors.forename: G
authors.initials: G
authors.lastname: Silbernagel
authors.forename: M M
authors.initials: MM
authors.lastname: Hoffmann
authors.forename: T B
authors.initials: TB
authors.lastname: Grammer
authors.forename: B O
authors.initials: BO
authors.lastname: Boehm
authors.forename: W
authors.initials: W
authors.lastname: März
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality; D016757:Death, Sudden, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid