title: Uric acid is an independent predictor of cardiovascular events in post-menopausal women.
abstract: BACKGROUND
  Uric acid (UA) is a risk factor for cardiovascular (CV) disease. In post-menopause UA levels are increased and strongly associated with subclinical organ damage. We investigated the prognostic significance of UA levels in predicting CV morbidity and mortality in post-menopausal women.
  
  
  METHODS
  We considered 645 post-menopausal outpatients not taking hormone replacement therapy or any drugs interfering with UA levels. We evaluated major adverse cardiovascular events (MACE) as primary endpoint, with coronary, stroke or total events as secondary endpoint. Survival curves for tertiles of UA were obtained by using the Kaplan-Meier and Mantel methods. Effect of prognostic factors on survival was evaluated by multivariable Cox regression model, considering P<0.05 as statistically significant.
  
  
  RESULTS
  During a mean (SD) follow-up at 72.5 (23.5) months, there were 90 new CV events (2.31%): 62 coronary and 28 cerebrovascular events. The rate of nonfatal CV events (3.15% versus 2.03% and 1.52%, P=0.009) as well as that of MACE (3.23% versus 2.11% and 1.59%, P=0.011) were significantly higher in the third tertile than in the other two groups. Interestingly, cerebrovascular (1.15% versus 0.62% and 0.30%, P=0.027) but not coronary events were significantly different among the three groups. In the Cox regression model, UA was independently and strongly associated with the incident risk of MACE (HR=1.248, P=0.001), cerebrovascular (HR=1.657, P<0.0001) and total events (HR=1.391, P<0.0001).
  
  
  CONCLUSIONS
  In post-menopause, independently of other CV risk factors and menopause duration, UA levels are associated with increased risk of death and MACE, in particular cerebrovascular but not coronary events.
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy. Electronic address: sciacqua@unicz.it.
authors.forename: Angela
authors.initials: A
authors.lastname: Sciacqua
authors.affiliation: Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Perticone
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy.
authors.forename: Eliezer J
authors.initials: EJ
authors.lastname: Tassone
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cimellaro
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy.
authors.forename: Sofia
authors.initials: S
authors.lastname: Miceli
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Maio
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sesti
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perticone
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood*; D011237:Predictive Value of Tests; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid
keywords: Cardiovascular events; Hyperuricemia; Post-menopause; Uric acid