title: Prognostic value of uric acid in patients with ST-elevated myocardial infarction undergoing primary coronary intervention.
abstract: Elevated uric acid (UA) levels have been associated with cardiovascular disease in epidemiologic studies. The relation between UA levels and long-term outcomes in patients with ST-segment elevation myocardial infarction who undergo primary percutaneous coronary intervention is not known. Data from 2,249 consecutive patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were evaluated. Patients were divided into 2 groups with high or low UA using upper limits of normal of 6 mg/dl for women and 7 mg/dl for men. There were 1,643 patients in the low-UA group (mean age 55.9 ± 11.6 years, 85% men) and 606 patients in the high-UA group (mean age 60.5 ± 12.6 years, 76% men). Serum UA levels were 8.0 ± 1.5 mg/dl in the high-UA group and 5.2 ± 1.0 mg/dl in the low-UA group (p <0.001). The in-hospital mortality rate was significantly higher in patients with high UA levels (9% vs 2%, p <0.001), as was the rate of adverse outcomes in patients with high UA. The mean follow-up time was 24.3 months. Cardiovascular mortality, reinfarction, target vessel revascularization, heart failure, and major adverse cardiac events were all significantly higher in the high-UA group. In a multivariate analyses, high plasma UA levels were an independent predictor of major adverse cardiac events in the hospital (odds ratio 2.03, 95% confidence interval 1.25 to 3.75, p = 0.006) and during long-term follow-up (odds ratio 1.64, 95% confidence interval 1.05 to 2.56, p = 0.03). In conclusion, high UA levels on admission are independently associated with in-hospital and long-term adverse outcomes in patients with ST-segment elevation myocardial infarction who undergo primary percutaneous coronary intervention.
authors.affiliation: Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey. drmgkaya@yahoo.com
authors.forename: Mehmet G
authors.initials: MG
authors.lastname: Kaya
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Mahmut
authors.initials: M
authors.lastname: Akpek
authors.forename: Nihat
authors.initials: N
authors.lastname: Kalay
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ergelen
authors.forename: Erkan
authors.initials: E
authors.lastname: Ayhan
authors.forename: Turgay
authors.initials: T
authors.lastname: Isik
authors.forename: Gokhan
authors.initials: G
authors.lastname: Cicek
authors.forename: Deniz
authors.initials: D
authors.lastname: Elcik
authors.forename: Omer
authors.initials: O
authors.lastname: Sahin
authors.forename: Said M
authors.initials: SM
authors.lastname: Cosgun
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Oguzhan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
authors.forename: C Michael
authors.initials: CM
authors.lastname: Gibson
mesh_terms: D000367:Age Factors; D015906:Angioplasty, Balloon, Coronary; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000628:therapy*; D011379:Prognosis; D012008:Recurrence; D019233:Retreatment; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid