title: On-admission serum uric acid predicts outcomes after acute myocardial infarction: systematic review and meta-analysis of prognostic studies.
abstract: OBJECTIVE
  To evaluate the prognostic value of serum uric acid (SUA) in acute myocardial infarction (AMI) patients.
  
  
  METHODS
  Systematic review and random-effects meta-analysis of prognostic studies assessing AMI outcomes (death, major adverse cardiac events, MACE) in relation to on-admission SUA.
  
  
  RESULTS
  Nine studies (7655 patients) were identified, 6 in the ST-segment elevation AMI patients treated with invasive revascularization and three in mixed AMI type cohorts with variable reperfusion strategies. "High" SUA (vs "low," different cut-offs) was univariately associated with higher short-term mortality (8 studies/6805 patients; odds ratio [OR], 3.24; 95% confidence interval [CI], 2.47-4.27) and incidence of MACE (7/6467; OR, 2.46; 95% CI, 1.84-3.27, moderate heterogeneity, mild bias), and with higher medium-term mortality (5/5194; OR, 2.69; 95% CI, 2.00-3.62, moderate heterogeneity, mild bias) and MACE (4/4299; OR, 1.93; 95% CI, 1.36-2.74, high heterogeneity, mild bias). It was independently associated with a higher short-term (4/3625; OR, 2.26, 95% CI, 1.85-2.77) and medium/long-term (3/2683; hazard ratio [HR], 1.30; 95% CI 1.01-1.68, moderate heterogeneity, mild bias) occurrence of poor outcomes (death/MACE). As a continuous variable (by 50 μmol/L), higher SUA was also independently associated with poorer medium/long-term outcomes (4/3533; HR, 1.19; 95% CI, 1.03-1.37, high heterogeneity, mild bias). All individual study effects (unadjusted or adjusted) were in the same direction, but differed in size. Heterogeneity was mainly due to the included AMI type and/or definition of MACE. All bias-corrected pooled effects remained significant.
  
  
  CONCLUSIONS
  Based on the available data, high(er) on-admission SUA independently predicts worse short-term and medium/long-term outcomes after AMI. However, the number of data are modest and additional prospective studies are warranted.
authors.affiliation: Department of Pharmacology, Zagreb University School of Medicine, Salata 11, 10000 Zagreb, Croatia.vtrkulja@mef.hr
authors.forename: Vladimir
authors.initials: V
authors.lastname: Trkulja
authors.forename: Sinisa
authors.initials: S
authors.lastname: Car
mesh_terms: D015415:Biomarkers / Q000097:blood; D005500:Follow-Up Studies; D014943:Global Health; D006801:Humans; D007902:Length of Stay / Q000639:trends; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality; D010343:Patient Admission; D011379:Prognosis; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid