title: Uric acid in-hospital changes predict mortality in patients with acute myocardial infarction.
abstract: OBJECTIVE
  The prognostic impact of admission uric acid (UA) levels in patients with acute myocardial infarction (AMI) is controversial. We assessed the prognostic role of in-hospital UA changes in patients with AMI.
  
  
  RESULTS
  We studied 375 consecutive patients (320 males, mean age 62.6 years) with AMI (232 with ST elevation MI) within 12 h of symptoms' onset. UA levels were daily measured throughout hospitalization and their admission and peak values were recorded. End-points were 30-day and 1-year mortality. Mortality rate at 30 days was 7.2% and at 1 year 10.9%. Patients who died within 30 days exhibited higher peak UA (10.24 mg/dl vs. 7.06 mg/dl, p < 0.001) and absolute UA elevation (1.7 mg/dl vs. 0.7 mg/dl, p < 0.001). Optimal values for predicting 30-day mortality were 9.65 mg/dl for peak UA and 2.35 mg/dl for UA elevation. Concerning 1-year mortality, deceased patients had higher peak UA levels (9.71 mg/dl vs. 7 mg/dl, p < 0.001) and absolute UA elevation (1.5 mg/dl vs. 0.6 mg/dl, p < 0.001). Optimal values for predicting 1-year mortality were 9.55 mg/dl for peak UA and 1.1 mg/dl for UA elevation. With Cox regression analysis peak UA (adjHR 1.157, p = 0.030) and UA elevation (adjHR 1.288, p = 0.009) were independent predictors of 30-day mortality. Similarly, peak UA levels (adjHR 1.204, p = 0.001) and UA elevation (adjHR 1.213, p = 0.001) predicted 1-year mortality.
  
  
  CONCLUSIONS
  In patients with AMI peak rather than admission UA levels, and absolute in-hospital UA elevation predict both 30-day and 1-year mortality. Serial in-hospital UA measurements add prognostic information in AMI patients.
authors.affiliation: First Cardiology Clinic, University of Athens Medical School, Hippokration Hospital, Athens, Greece. Electronic address: glaz35@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Lazaros
authors.forename: D
authors.initials: D
authors.lastname: Tsiachris
authors.forename: K
authors.initials: K
authors.lastname: Aznaouridis
authors.forename: C
authors.initials: C
authors.lastname: Vlachopoulos
authors.forename: C
authors.initials: C
authors.lastname: Tsioufis
authors.forename: C
authors.initials: C
authors.lastname: Chrysohoou
authors.forename: A
authors.initials: A
authors.lastname: Patialiakas
authors.forename: C
authors.initials: C
authors.lastname: Masoura
authors.forename: C
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014527:Uric Acid / Q000008:administration & dosage / Q000097:blood*
chemical_list: D014527:Uric Acid
keywords: Acute myocardial infarction; Mortality; Risk stratification; Uric acid levels