title: Determinants and Prognostic Impact of Hyperuricemia in Hospitalization for Acute Heart Failure.
abstract: BACKGROUND
  Hyperuricemia is a prognostic factor in patients with chronic heart failure, but whether uric acid level can predict clinical outcome of acute heart failure (AHF) remains to be elucidated. We therefore investigated the association of uric acid with mortality in patients hospitalized for AHF.
  
  
  RESULTS
  Data for patients hospitalized for AHF were drawn from an intramural registry. Biochemistry data, echocardiographic characteristics, and uric acid level were collected. National Death Registry was linked for the identification of mortality data. Among a total of 1,835 participants (age, 75 ± 13 years, 68% men), 794 patients died during follow-up. Patients who died were older, had lower hemoglobin and estimated glomerular filtration rate, and higher pulmonary artery systolic pressure, NT-proBNP, and uric acid. Uric acid was a significant predictor of mortality on univariate analysis (HR per 1 SD, 1.18; 95% CI: 1.11-1.26) and in multivariate Cox models (HR, 1.15; 95% CI: 1.02-1.29). Survival analysis showed an increasing risk of death along the quartile distribution of uric acid level. Given renal function, cardiac performance, and kidney perfusion as major determinants of hyperuricemia, the prognostic impact of uric acid level was diminished as renal function deteriorated.
  
  
  CONCLUSIONS
  Uric acid level was an independent predictor of mortality in patients hospitalized for AHF, but the prognostic impact of hyperuricemia was attenuated by worsening renal function.
authors.affiliation: Department of Medicine, Taipei Veterans General Hospital.
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Huang
authors.forename: Pai-Feng
authors.initials: PF
authors.lastname: Hsu
authors.forename: Hao-Min
authors.initials: HM
authors.lastname: Cheng
authors.forename: Dai-Yin
authors.initials: DY
authors.lastname: Lu
authors.forename: Yu-Lun
authors.initials: YL
authors.lastname: Cheng
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Guo
authors.forename: Shih-Hsien
authors.initials: SH
authors.lastname: Sung
authors.forename: Wen-Chung
authors.initials: WC
authors.lastname: Yu
authors.forename: Chen-Huan
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate; D013624:Taiwan; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid