title: The impact of uric acid on long-term mortality in patients with asymptomatic carotid atherosclerotic disease.
abstract: BACKGROUND
  Serum uric acid (SUA) has been discussed to be related to cardiovascular (CV) disease and outcome. We investigated whether levels of SUA predict long-term mortality in neurologically asymptomatic patients with carotid atherosclerotic disease.
  
  
  METHODS
  We prospectively studied 959 consecutive patients with carotid atherosclerosis as evaluated by duplex Doppler sonography for all-cause and CV death, respectively.
  
  
  RESULTS
  During a median follow-up time of 6.3 years (interquartile range [IQR], 5.4-7.1 years), 246 deaths (25.7%), including 160 CV deaths (16.7%), were recorded. Median baseline SUA levels were 5.9 mg/dL (IQR, 5.0-7.0 mg/dL). SUA was significantly associated with all-cause death and CV death. Adjusted hazard ratios (HRs) for an increase of 1 mg/dL of SUA levels were 1.12 (95% confidence interval [CI], 1.04-1.21; P = .003) and 1.20 (95% CI, 1.11-1.30; P < .001) for all-cause and CV death, respectively. Quartiles of SUA levels showed a significant association with CV mortality (log-rank P = .002). For CV death, adjusted HRs for quartiles of increasing SUA levels were 1.45 (95% CI, .87-2.43), 1.44 (95% CI, .85-2.46), and 2.26 (95% CI, 1.36-3.76; P < .01), compared with the lowest quartile, respectively. Patients with baseline carotid stenosis of more than 50% and/or increased levels of SUA (≥median) had an approximately 2-fold increase in risk of (CV) death, compared with patients with carotid narrowing of less than 50% and/or SUA levels less than the median (P < .001).
  
  
  CONCLUSIONS
  Levels of SUA represent independent predictors for CV mortality in a cohort of patients with asymptomatic carotid atherosclerosis.
authors.affiliation: Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria; Department of Clinical Pathobiochemistry, University of Dresden, Dresden, Germany; Institute of Clinical Chemistry and Laboratory Medicine, University of Dresden, Dresden, Germany. Electronic address: florian.mayer@uniklinikum-dresden.de.
authors.forename: Florian J
authors.initials: FJ
authors.lastname: Mayer
authors.affiliation: Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Christine
authors.initials: C
authors.lastname: Mannhalter
authors.affiliation: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
authors.affiliation: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.affiliation: Department of Clinical Pathobiochemistry, University of Dresden, Dresden, Germany; Institute of Clinical Chemistry and Laboratory Medicine, University of Dresden, Dresden, Germany.
authors.forename: Triantafyllos
authors.initials: T
authors.lastname: Chavakis
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University of Dresden, Dresden, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Siegert
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University of Dresden, Dresden, Germany.
authors.forename: Borros M
authors.initials: BM
authors.lastname: Arneth
authors.affiliation: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Renate
authors.initials: R
authors.lastname: Koppensteiner
authors.affiliation: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hoke
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000401:mortality*; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000097:blood* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: Carotid atherosclerosis; biomarker; risk factor; uric acid