Predictive Value of Elevated Uric Acid in Turkish Patients Undergoing Primary Angioplasty for ST Elevation Myocardial Infarction.
BACKGROUND
Uric acid (UA) is an independent risk factor for the development of coronary heart disease. Serum UA levels have been correlated with all major forms of death from cardiovascular disease, including acute, subacute, and chronic forms of coronary artery disease (CAD), heart failure, and stroke. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the prognostic value of UA in patients with STEMI undergoing primary percutaneous coronary intervention (PCI).


METHODS
We prospectively enrolled 434 consecutive Turkish STEMI patients (mean age 55.4 ± 12.4 years, 341 male, 93 female) undergoing primary PCI. The study population was divided into tertiles based on admission UA values. The high UA group (n = 143) was defined as a value in the third tertile (> 5.7 mg/dl), and the low UA group (n = 291) included those patients with a value in the lower two tertiles (≤ 5.7 mg/dl). Clinical characteristics, in-hospital and six-month outcomes of primary PCI were analyzed.


RESULTS
Compared to the low UA group, only Killip class > 1 at admission was more prevalent in the high UA group (3.4% vs. 17.5%, p < 0.001, respectively). Higher in-hospital cardiovascular mortality and six-month all-cause mortality rates were observed in the high UA group than in the lower group (12.6% vs. 1.7%, respectively, p < 0.001) and (19.6% vs. 4.1%, respectively, p < 0.001). In Cox multivariate analysis; a high admission UA value (> 5.7 mg/dl) was found to be a powerful independent predictor of six-month all-cause mortality (hazard ratio: 5.57, 95% confidence interval: 1.903-16.3, p = 0.002).


CONCLUSIONS
These results suggest that a high level of UA on admission was associated with increased in-hospital cardiovascular mortality, and six-month all-cause mortality in Turkish patients with STEMI undergoing primary PCI.


BACKGROUND
Primary angioplasty; ST elevation myocardial infarction; Uric acid.
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Ozgur
O
Akgul
Department of Cardiology, Bezmialem Vak1f University, School of Medicine, Istanbul, Turkey;
Huseyin
H
Uyarel
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Hamdi
H
Pusuroglu
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Mehmet
M
Gul
Department of Biochemistry, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Nilgun
N
Isiksacan
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Selahattin
S
Turen
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Mehmet
M
Erturk
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Ozgur
O
Surgit
Department of Cardiology, Rize Education and Research Hospital, Rize, Turkey.
Mustafa
M
Cetin
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Umit
U
Bulut
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Omer Faruk
OF
Baycan
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey;
Nevzat
N
Uslu