title: Uric Acid Is Associated With Inflammation, Coronary Microvascular Dysfunction, and Adverse Outcomes in Postmenopausal Women.
abstract: Uric acid is a risk factor for coronary artery disease in postmenopausal women, but the association with inflammation and coronary endothelial dysfunction (CED) is not well defined. The aim of this study was to determine the relationship of serum uric acid (SUA), inflammatory markers, and CED. In this prospective cohort study, SUA, high-sensitivity C-reactive protein levels, and neutrophil count were measured in 229 postmenopausal women who underwent diagnostic catheterization, were found to have no obstructive coronary artery disease, and underwent coronary microvascular function testing, to measure coronary blood flow response to intracoronary acetylcholine. The average age was 58 years (interquartile range, 52-66 years). Hypertension was present in 48%, type 2 diabetes mellitus in 5.6%, and hyperlipidemia in 61.8%. CED was diagnosed in 59% of postmenopausal women. Mean uric acid level was 4.7±1.3 mg/dL. Postmenopausal women with CED had significantly higher SUA compared with patients without CED (4.9±1.3 versus 4.4±1.3 mg/dL; P=0.02). There was a significant correlation between SUA and percent change in coronary blood flow to acetylcholine (P=0.009), and this correlation persisted in multivariable analysis. SUA levels were significantly associated with increased neutrophil count (P=0.02) and high-sensitivity C-reactive protein levels (P=0.006) among patients with CED, but not among those without CED. SUA is associated with CED in postmenopausal women and may be related to inflammation. These findings link SUA levels to early coronary atherosclerosis in postmenopausal women.
authors.affiliation: From the Division of Cardiovascular Diseases (M.P., J.H., C.S.R., L.O.L., A.L.) and Division of Rheumatology (E.L.M.), Mayo Clinic, Rochester, MN.
authors.forename: Megha
authors.initials: M
authors.lastname: Prasad
authors.affiliation: From the Division of Cardiovascular Diseases (M.P., J.H., C.S.R., L.O.L., A.L.) and Division of Rheumatology (E.L.M.), Mayo Clinic, Rochester, MN.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Matteson
authors.affiliation: From the Division of Cardiovascular Diseases (M.P., J.H., C.S.R., L.O.L., A.L.) and Division of Rheumatology (E.L.M.), Mayo Clinic, Rochester, MN.
authors.forename: Joerg
authors.initials: J
authors.lastname: Herrmann
authors.affiliation: From the Division of Cardiovascular Diseases (M.P., J.H., C.S.R., L.O.L., A.L.) and Division of Rheumatology (E.L.M.), Mayo Clinic, Rochester, MN.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gulati
authors.affiliation: From the Division of Cardiovascular Diseases (M.P., J.H., C.S.R., L.O.L., A.L.) and Division of Rheumatology (E.L.M.), Mayo Clinic, Rochester, MN.
authors.forename: Charanjit S
authors.initials: CS
authors.lastname: Rihal
authors.affiliation: From the Division of Cardiovascular Diseases (M.P., J.H., C.S.R., L.O.L., A.L.) and Division of Rheumatology (E.L.M.), Mayo Clinic, Rochester, MN.
authors.forename: Lilach O
authors.initials: LO
authors.lastname: Lerman
authors.affiliation: From the Division of Cardiovascular Diseases (M.P., J.H., C.S.R., L.O.L., A.L.) and Division of Rheumatology (E.L.M.), Mayo Clinic, Rochester, MN. lerman.amir@mayo.edu.
authors.forename: Amir
authors.initials: A
authors.lastname: Lerman
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood*; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: acetylcholine; hypertension; inflammation; risk factors; uric acid