Uric acid levels predict death in acute coronary syndrome

Gjin Ndrepepa, M.D., of the Deutsches Herzzentrum in Munich, Germany, and colleagues conducted a study involving 5,124 patients with acute coronary syndrome who underwent percutaneous coronary intervention (PCI) to evaluate whether uric acid levels have any prognostic value in this patient population. Of the participants, 1,629 had acute ST-segment elevation myocardial infarction (STEMI), 1,332 had acute non-STEMI, and 2,163 had unstable angina. Participants were classified into four uric acid quartiles: quartile 1 (1.3 to <5.3 mg/dL), quartile 2 (5.3 to <6.3 mg/dL), quartile 3 (6.3 to <7.5 mg/dL), and quartile 4 (7.5 to 18.4 mg/dL). One-year mortality was the primary end point.

During follow-up, the researchers identified 450 deaths: 80 deaths in quartile 1, 77 in quartile 2, 72 in quartile 3, and 221 in quartile 4 (unadjusted hazard ratio, 3.05 for fourth versus first quartile uric acid). The association between uric acid and mortality persisted after adjustment, with every 1-mg/dL increase in the uric acid level correlating with a 12 percent increase in the adjusted risk for one-year mortality.

"Elevated levels of uric acid are an independent predictor of one-year mortality across the whole spectrum of patients with acute coronary syndromes treated with percutaneous coronary intervention," the authors write.

More information: The American journal of cardiology, 1 May 2012, v. 109, 9 , pp. 1260-1265. DOI: 10.1016/j.amjcard.2011.12.018)

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