Correlations between serum uric acid and coronary atherosclerosis before and during statin therapy.
OBJECTIVE
The role of serum uric acid (UA) in the pathophysiology of atherosclerosis is ambiguous and remains controversial. The purpose of the present study was to evaluate the relationship between serum UA and coronary atherosclerosis.


METHODS
Coronary atherosclerosis in the nonculprit lesions was evaluated using virtual histology intravascular ultrasound in 119 patients with angina pectoris at the time of percutaneous coronary intervention and 8 months after statin therapy.


RESULTS
Serum UA levels showed weak but significant positive correlations with external elastic membrane volume (baseline: r=0.236, P=0.02; 8-month follow-up: r=0.307, P=0.0009) and with plaque volume (baseline: r=0.263, P=0.007; 8-month follow-up: r=0.349, P=0.0001). Significant decreases in the fibrofatty and fibrous components and increases in the necrotic core and dense calcium components were observed during statin therapy. Serum UA (r=0.257, P=0.009) and unstable angina pectoris (r=0.208, P=0.02) correlated significantly with change in the calcified plaque volume, whereas the estimated glomerular filtration rate trended (r=-0.166, P=0.07). Multivariate regression analyses showed that UA was a significant independent predictor associated with an increase in the dense calcium plaque volume during statin therapy (β=0.244, P=0.03).


CONCLUSIONS
In this preliminary study, serum UA levels correlated with coronary atherosclerosis before and during statin therapy. It remains unknown whether these correlations are a direct effect of UA itself or a marker of increased risk.
aDivision of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations bDepartment of Cardiology, Tsurumi Nishiguchi Hospital cDepartment of Cardiology, Yokohama Seamen's Insurance Hospital dDepartment of Cardiology, Kanagawa Cardiovascular and Respiratory Center eDivision of Cardiology, Yokohama City University Medical Center, Yokohama fDepartment of Cardiology, Hiratsuka Kyosai Hospital, Hiratsuka gFourth Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki hCardiovascular Imaging Center, Toyohashi, Japan.
Tsuyoshi
T
Nozue
Shingo
S
Yamamoto
Shinichi
S
Tohyama
Kazuki
K
Fukui
Shigeo
S
Umezawa
Yuko
Y
Onishi
Tomoyuki
T
Kunishima
Kiyoshi
K
Hibi
Mitsuyasu
M
Terashima
Ichiro
I
Michishita
D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014527:Uric Acid / Q000097:blood*
D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014527:Uric Acid