title: Serum uric acid and eGFR_CKDEPI differently predict long-term cardiovascular events and all causes of deaths in a residential cohort.
abstract: OBJECTIVE
  Serum uric acid (SUA) and estimated glomerular filtration rate (eGFR) were separately assessed as risk factors for incident coronary hard (CHDH), cardiovascular disease (CVDH) or all-cause (ALL) deaths but never concomitantly in a residential cohort.
  
  
  METHODS
  Men and women aged 35-74years, totaling 2888 subjects were followed 13.5-19.5years for incident CVDH, CHDH and ALL deaths. Systematic comparisons among different end-points were based on: age, gender, systolic blood pressure (SBP), total and HDL cholesterol, cigarette consumption, body mass index, blood glucose, SUA, eGFR from the Chronic Kidney Disease Prognosis Consortium (eGFR_CKDEPI) and (eGFR_CKDEPI)(2).
  
  
  RESULTS
  Significant (p<0.00001) differences in SUA quintiles were seen for SBP, total and HDL cholesterol, body mass index and eGFR_CKDEPI whereas cigarettes and blood glucose were not statistically different. There were increasingly larger proportions of all events in SUA quintiles (0.05>p<0.0001). Among 4 major continuous variables, SUA was largely accurate (ROC>0.610) to predict all end-points whereas eGFR_CKDEPI was the worse univariate predictor. Multivariately, age, gender, SBP and cigarettes were significant predictors for all end-points. Total cholesterol was a significant predictor only for CHDH events. Blood glucose and SUA were contributors for CVDH events (RR, for 1mg/dl of SUA, 1.09, 95%CI 1.01-1.17), CVD deaths (RR 1.11, 95%CI 1.03-1.20) and ALL deaths (RR 1.08, 95%CI 1.03-1.14) whereas (eGFR_CKDEPI)(2) was for ALL deaths only (RR 1.02, 95%CI 1.00-1.04).
  
  
  CONCLUSIONS
  SUA is a predictor of long-term incidence of cardiovascular events and deaths and all-cause mortality and should be considered for risk predictive purposes and instruments whereas eGFR_CKDEPI only predicts all-cause mortality by a U-shaped relation.
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, I-00161 Rome, Italy. Electronic address: paoloemilio.puddu@uniroma1.it.
authors.forename: Paolo Emilio
authors.initials: PE
authors.lastname: Puddu
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Via Salvador Allende 43, 84081 Baronissi (SA), Italy. Electronic address: giancarlo.bilancio@gmail.com.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Bilancio
authors.affiliation: Centre of Preventive Medicine, Gubbio, Italy. Electronic address: oscar.terradura@gmail.com.
authors.forename: Oscar
authors.initials: O
authors.lastname: Terradura Vagnarelli
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Via Salvador Allende 43, 84081 Baronissi (SA), Italy. Electronic address: cinlomb@inwind.it.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Lombardi
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. Electronic address: mariomancini30@virgilio.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Mancini
authors.affiliation: Istituto Auxologico Italiano, Milan, Italy; University of Milan, Milan, Italy. Electronic address: alberto.zanchetti@unimi.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zanchetti
authors.affiliation: Associazione per la Ricerca Cardiologica, Via Latina 49, 00179 Roma, Italy. Electronic address: menottia@tin.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Menotti
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D002423:Cause of Death / Q000639:trends; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D012307:Risk Factors; D013997:Time Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: CVD risk; Glomerular filtration rate; Gubbio study; Prediction; Residential cohort; Serum uric acid