title: Silent Monosodium Urate Crystal Deposits Are Associated With Severe Coronary Calcification in Asymptomatic Hyperuricemia: An Exploratory Study.
abstract: To evaluate the association between monosodium urate (MSU) crystal deposits in patients with asymptomatic hyperuricemia and the severity and extension of coronary artery disease (CAD).
  
  
  
  In this cross-sectional study, consecutive inpatients with a non-ST elevation acute coronary event and asymptomatic hyperuricemia (serum uric acid concentration of ≥7.0 mg/dl) or normouricemia (serum uric acid concentration of <7.0 mg/dl) were enrolled. In patients with asymptomatic hyperuricemia, the presence of MSU crystals was determined by ultrasound evaluation of both knees and first metatarsophalangeal joints and by compensated polarized light microscopy. CAD was assessed by coronary angiography, and the following variables were considered: 1) the presence of moderate-to-severe coronary artery calcification, 2) the number of significant coronary stenoses, and 3) the presence of multivessel disease. The association between variables indicating the severity of CAD and the presence of MSU crystals was analyzed by multivariate regression.
  
  
  
  One hundred forty patients were enrolled. After ultrasonography and microscopic analyses were performed, the patients were classified as having normouricemia (n = 66), asymptomatic hyperuricemia alone (n = 61), and asymptomatic hyperuricemia with MSU crystals (n = 13). The prevalence of moderate-to-severe coronary calcification was significantly higher in the patients with asymptomatic hyperuricemia with MSU crystals compared with patients with asymptomatic hyperuricemia alone and patients with normouricemia (P = 0.003). An independent association was observed between the presence of moderate-to-severe calcification and asymptomatic hyperuricemia with crystals (odds ratio 16.8, P = 0.002). No significant association was observed for the other variables.
  
  
  
  Silent deposition of MSU crystals in patients with asymptomatic hyperuricemia was associated with more severe coronary calcification, which suggests more severe CAD in relation to crystal deposition.
authors.affiliation: Hospital General Universitario de Elda and Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: Mariano
authors.identifier: 0000-0002-0219-9055
authors.initials: M
authors.lastname: Andrés
authors.affiliation: Hospital General Universitario de Elda, Alicante, Spain.
authors.forename: María-Amparo
authors.initials: MA
authors.lastname: Quintanilla
authors.affiliation: Hospital General Universitario de Elda, Alicante, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: Sivera
authors.affiliation: Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Sánchez-Payá
authors.affiliation: Hospital General Universitario de Alicante and Universidad Miguel Hernández, Alicante, Spain.
authors.forename: Eliseo
authors.initials: E
authors.lastname: Pascual
authors.affiliation: Hospital General Universitario de Alicante and Universidad Miguel Hernández, Alicante, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Vela
authors.affiliation: Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: Juan-Miguel
authors.initials: JM
authors.lastname: Ruiz-Nodar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D003324:Coronary Artery Disease / Q000209:etiology*; D003430:Cross-Sectional Studies; D003460:Crystallization; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D014527:Uric Acid / Q000378:metabolism*; D061205:Vascular Calcification / Q000209:etiology*
chemical_list: D014527:Uric Acid