title: Hyperuricemia and the risk for coronary heart disease morbidity and mortality a systematic review and dose-response meta-analysis.
abstract: Considerable controversy exists regarding the association between hyperuricemia and coronary heart disease (CHD). Therefore, we performed a systematic review and dose-response meta-analysis of prospective studies to examine the controversy. Prospective cohort studies with relative risks (RRs) and 95% confidence intervals (CIs) for CHD according to serum uric acid levels in adults were eligible. A random-effects model was used to compute the pooled risk estimate. The search yielded 29 prospective cohort studies (n = 958410 participants). Hyperuricemia was associated with increased risk of CHD morbidity (adjusted RR 1.13; 95% CI 1.05 to 1.21) and mortality (adjusted RR 1.27; 95% CI 1.16 to 1.39). For each increase of 1 mg/dl in uric acid level, the pooled multivariate RR of CHD mortality was 1.13 (95% CI 1.06 to 1.20). Dose-response analysis indicated that the combined RR of CHD mortality for an increase of 1 mg uric acid level per dl was 1.02 (95% CI 0.84 to 1.24) without heterogeneity among males (P = 0.879, I(2) = 0%) and 2.44 (95% CI 1.69 to 3.54) without heterogeneity among females (P = 0.526, I(2) = 0%). The increased risk of CHD associated with hyperuricemia was consistent across most subgroups. Hyperuricemia may increase the risk of CHD events, particularly CHD mortality in females.
authors.affiliation: Department of Neurology, The Second Affiliated Hospital to Nanchang University, Nanchang 330006, People's Republic of China.
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Anaesthesiology, The Second Affiliated Hospital to Nanchang University, Nanchang 330006, People's Republic of China.
authors.forename: Xiaolan
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital to Nanchang University, Nanchang 330006, People's Republic of China.
authors.forename: Yingli
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of Neurology, The Second Affiliated Hospital to Nanchang University, Nanchang 330006, People's Republic of China.
authors.forename: Kun
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Neurology, The Second Affiliated Hospital to Nanchang University, Nanchang 330006, People's Republic of China.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The Second Affiliated Hospital to Nanchang University, Nanchang 330006, People's Republic of China.
authors.forename: Wenshang
authors.initials: W
authors.lastname: Hou
authors.affiliation: Department of Neurology, The Second Affiliated Hospital to Nanchang University, Nanchang 330006, People's Republic of China.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Tang
mesh_terms: D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000150:complications*; D008297:Male; D009017:Morbidity; D009026:Mortality; D016017:Odds Ratio; D012307:Risk Factors
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