title: Hyperuricemia as an independent risk factor for major cardiovascular events: a 10-year cohort study from Southern Italy.
abstract: OBJECTIVE
  To date, whether hyperuricemia may represent a marker or an independent risk factor for cardiovascular disease remains unclear. This study aimed at assessing the role of hyperuricemia in the onset of major cardiovascular events (MACE).
  
  
  METHODS
  Baseline clinical data were collected through a 1998/1999 longitudinal survey as part of the larger Valle dell'Irno Prevenzione Project. Ten years later, MACE incidence was evaluated.
  
  
  RESULTS
  A total of 1175 patients (50% men, aged 25-74 years) completed the study. At least one MACE was reported by 135 patients, whose mean uric acid values were significantly higher compared with patients without events (6.0 ± 4.8 and 4.6 ± 4.0 mg/dl, respectively; P < 0.01). Patients with uric acid values of at least 6 mg/dl (prevalence of 14.6%) had significantly lower levels of high-density lipoprotein cholesterol and increased values of BMI, blood pressure (BP), cholesterol, triglycerides, white blood cells, complement component 3 (C3) and creatinine. After subgrouping patients in tertiles and considering the first one as reference [odds ratio (OR): 1], the OR (95% confidence interval) was 1.44 (0.7-2.9) in the second and 2.2 (1.3-3.5) in the third tertile, respectively. Confounder-adjusted stepwise linear regression revealed uric acid, age, creatinine, glucose and systolic BP as independent predictors of MACE. Diastolic BP and creatinine were independently correlated with uric acid in the entire population, diastolic BP only in men and BMI, creatinine, age and C3 in women.
  
  
  CONCLUSIONS
  Hyperuricemia was shown to be a strong independent risk factor for MACE and should be included in cardiovascular prevention strategies. Whether hypouricemic drugs can decrease cardiovascular disease risk warrants further studies.
authors.affiliation: aUnità Operativa di Cardiologia ed UTIC - Ospedale "G.Fucito", Mercato S. Severino - Azienda Ospedaliera Universitaria di SalernobCanopo Centro Studi, Salerno, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Capuano
authors.forename: Federica
authors.initials: F
authors.lastname: Marchese
authors.forename: Rocco
authors.initials: R
authors.lastname: Capuano
authors.forename: Sergio
authors.initials: S
authors.lastname: Torre
authors.forename: Anna G
authors.initials: AG
authors.lastname: Iannone
authors.forename: Eduardo
authors.initials: E
authors.lastname: Capuano
authors.forename: Norman
authors.initials: N
authors.lastname: Lamaida
authors.forename: Matteo
authors.initials: M
authors.lastname: Sonderegger
authors.forename: Ernesto
authors.initials: E
authors.lastname: Capuano
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000150:complications* / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors