Uric acid levels are associated with severity and mortality in patients with acute coronary syndrome
Acute coronary syndrome (ACS) causes a serious of coronary artery diseases that associated with sudden and reduced blood flow to the heart. The aim of this study was to assess the potential of serum uric acid (SUA) to predict severity and mortality in patients with ACS. According to their SUA levels, eligible participants were assigned into the Hyperuricemia group and the Normouricemia group (control group). All the patients were requested to enroll into a 1-year follow-up, and the final clinical outcomes included the SYNTAX and Gensini scores, major adverse cardiovascular events (MACEs), and cardiovascular mortality. In total, 874 participants were followed-up. Individuals with high levels of uric acid bore more disease vessels exhibited higher SYNTAX and Gensini scores. Besides, patients in the Hyperuricemia group showed elevated rates of MACE and cardiovascular mortality. High SUA level is positively associated with severity and mortality of patients with ACS. SUA might be a novel ACS prediction marker and risk factor in clinical diagnosis.
Pope JH, Aufderheide TP, Ruthazer R, Woolard RH, Feldman JA, Beshansky JR, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med 2000; 342(16): 1163–70. doi: 10.1056/NEJM200004203421603
Fromonot J, Dignat-Georges F, Rossi P, Mottola G, Kipson N, Ruf J, et al. Ticagrelor improves peripheral arterial function in acute coronary syndrome patients: relationship with adenosine plasma level. J Am Coll Cardiol 2016; 67(16): 1967–8. doi: 10.1016/j.jacc.2016.02.023
Fox KA, Cokkinos DV, Deckers J, Keil U, Maggioni A, Steg G. The ENACT study: a pan-European survey of acute coronary syndromes. European Network for Acute Coronary Treatment. Eur Heart J 2000; 21(17): 1440–9. doi: 10.1053/euhj.2000.2185
Kaya MG, Uyarel H, Akpek M, Kalay N, Ergelen M, Ayhan E, et al. Prognostic value of uric acid in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol 2012; 109(4): 486–91. doi: 10.1016/j.amjcard.2011.09.042
Kolansky DM. Acute coronary syndromes: morbidity, mortality, and pharmacoeconomic burden. Am J Manag Care 2009; 15(2 Suppl): S36–41.
Zhao S, Wang J, Ye F, Liu YM. Determination of uric acid in human urine and serum by capillary electrophoresis with chemiluminescence detection. Anal Biochem 2008; 378(2): 127–31. doi: 10.1016/j.ab.2008.04.014
Gaubert M, Marlinge M, Alessandrini M, Laine M, Bonello L, Fromonot J, et al. Uric acid levels are associated with endothelial dysfunction and severity of coronary atherosclerosis during a first episode of acute coronary syndrome. Purinergic Signal 2018; 14(2): 191–9. doi: 10.1007/s11302-018-9604-9
Liu PW, Chang TY, Chen JD. Serum uric acid and metabolic syndrome in Taiwanese adults. Metabolism 2010; 59(6): 802–7. doi: 10.1016/j.metabol.2009.09.027
Soltani Z, Rasheed K, Kapusta DR, Reisin E. Potential role of uric acid in metabolic syndrome, hypertension, kidney injury, and cardiovascular diseases: is it time for reappraisal? Curr Hypertens Rep 2013; 15(3): 175–81. doi: 10.1007/s11906-013-0344-5
Alderman MH, Cohen H, Madhavan S, Kivlighn S. Serum uric acid and cardiovascular events in successfully treated hypertensive patients. Hypertension 1999; 34(1): 144–50. doi: 10.1161/01.HYP.34.1.144
Kanbay M, Segal M, Afsar B, Kang DH, Rodriguez-Iturbe B, Johnson RJ. The role of uric acid in the pathogenesis of human cardiovascular disease. Heart 2013; 99(11): 759–66. doi: 10.1136/heartjnl-2012-302535
Jin H, Greenslade JH, Parsonage WA, Hawkins T, Than M, Cullen L. Does uric acid level provide additional risk stratification information in emergency patients with symptoms of possible acute coronary syndrome? Crit Pathw Cardiol 2016; 15(4): 169–73. doi: 10.1097/HPC.0000000000000092
Bekler A, Barutçu A, Tenekecioglu E, Altun B, Gazi E, Temiz A, et al. The relationship between fragmented QRS complexes and SYNTAX and Gensini scores in patients with acute coronary syndrome. Kardiol Pol 2015; 73(4): 246–54. doi: 10.5603/KP.a2014.0208
Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention 2005; 1(2): 219–27.
Lopez-Pineda A, Cordero A, Carratala-Munuera C, Orozco-Beltran D, Quesada JA, Bertomeu-Gonzalez V, et al. Hyperuricemia as a prognostic factor after acute coronary syndrome. Atherosclerosis 2018; 269: 229–35. doi: 10.1016/j.atherosclerosis.2018.01.017
Trepels T, Zeiher AM, Fichtlscherer S. [Acute coronary syndrome and inflammation. Biomarkers for diagnostics and risk stratification]. Herz 2004; 29(8): 769–76. doi: 10.1007/s00059-004-2637-6
Wang H, Liu Z, Shao J, Lin L, Jiang M, Wang L, et al. Immune and inflammation in acute coronary syndrome: molecular mechanisms and therapeutic implications. J Immunol Res 2020; 2020: 4904217. doi: 10.1155/2020/4904217
Bittner A, Alcaino H, Castro PF, Perez O, Corbalan R, Troncoso R, et al. Matrix metalloproteinase-9 activity is associated to oxidative stress in patients with acute coronary syndrome. Int J Cardiol 2010; 143(1): 98–100. doi: 10.1016/j.ijcard.2008.11.188
Luo CF, Mo P, Li GQ, Liu SM. Aspirin-omitted dual antithrombotic therapy in non-valvular atrial fibrillation patients presenting with acute coronary syndrome or undergoing percutaneous coronary intervention: results of a meta-analysis. Eur Heart J Cardiovasc Pharmacother 2021; 7(3): 218–24. doi: 10.1093/ehjcvp/pvaa016
Tarantini G, Mojoli M, Varbella F, Caporale R, Rigattieri S, Ando G, et al. Timing of oral P2Y12 inhibitor administration in patients with non-ST-segment elevation acute coronary syndrome. J Am Coll Cardiol 2020; 76(21): 2450–9. doi: 10.1016/j.jacc.2020.08.053
Cuisset T, Frere C, Quilici J, Morange PE, Camoin L, Bali L, et al. Relationship between aspirin and clopidogrel responses in acute coronary syndrome and clinical predictors of non response. Thromb Res 2009; 123(4): 597–603. doi: 10.1016/j.thromres.2008.04.003
Fuller R, Chavez B. Ticagrelor (brilinta), an antiplatelet drug for acute coronary syndrome. P T 2012; 37(10): 562–8.
Manner IW, Waldum-Grevbo B, Witczak BN, Baekken M, Oktedalen O, Os I, et al. Immune markers, diurnal blood pressure profile and cardiac function in virologically suppressed HIV-infected patients. Blood Press 2017; 26(6): 332–40. doi: 10.1080/08037051.2017.1346459
Yukizawa Y, Inaba Y, Kobayashi N, Ike H, Kubota S, Saito T. Selective pharmacological prophylaxis based on individual risk assessment using plasma levels of soluble fibrin and plasminogen-activator inhibitor-1 following total hip arthroplasty. Mod Rheumatol 2014; 24(5): 835–9. doi: 10.3109/14397595.2013.868781
Hennig F, Stepanenko AV, Lehmkuhl HB, Kukucka M, Dandel M, Krabatsch T, et al. Neurohumoral and inflammatory markers for prediction of right ventricular failure after implantation of a left ventricular assist device. Gen Thorac Cardiovasc Surg 2011; 59(1): 19–24. doi: 10.1007/s11748-010-0669-9
Stanek B, Frey B, Hulsmann M, Koller-Strametz J, Hartter E, Schuller M, et al. Validation of big endothelin plasma levels compared with established neurohumoral markers in patients with severe chronic heart failure. Transplant Proc 1997; 29(1–2): 595–6. doi: 10.1016/S0041-1345(96)00097-8
Mejer-Barczewska A, Kapusta J, Godala M, Kowalczyk E, Irzmanski R, Kowalski J. [Evaluation of oxidative-reduction markers of blood in patients with acute coronary syndromes (ACS) subjected to cardiac rehabilitation]. Pol Merkur Lekarski 2017; 42(252): 236–40.
Ryan RJ, Lindsell CJ, Hollander JE, O’Neil B, Jackson R, Schreiber D, et al. A multicenter randomized controlled trial comparing central laboratory and point-of-care cardiac marker testing strategies: the Disposition Impacted by Serial Point of Care Markers in Acute Coronary Syndromes (DISPO-ACS) trial. Ann Emerg Med 2009; 53(3): 321–8. doi: 10.1016/j.annemergmed.2008.06.464
Pan L, Han P, Ma S, Peng R, Wang C, Kong W, et al. Abnormal metabolism of gut microbiota reveals the possible molecular mechanism of nephropathy induced by hyperuricemia. Acta Pharm Sin B 2020; 10(2): 249–61. doi: 10.1016/j.apsb.2019.10.007
Yuan Y, Xu Z. Dual coronary embolization associated with atrial fibrillation: a case report. STEMedicine 2021; 2(8): e99. doi: 10.37175/stemedicine.v2i8.99
Ciccarelli G, Mangiacapra F, Pellicano M, Barbato E. Correlation between serum uric acid levels and residual platelet reactivity in patients undergoing PCI. Nutr Metab Cardiovasc Dis 2017; 27(5): 470–1. doi: 10.1016/j.numecd.2017.02.006
Copyright (c) 2022 Hui Feng, Huaping Pan, Wei Yao
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain full copyright to their individual works, and publishing rights without restrictions.
In accordance with the Budapest Open Access Initiative, articles published in STEMedicine are freely available "on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited."
Except where otherwise noted, all content on this website is licensed under a Creative Commons Attribution 4.0 License. This license allows for commercial and non-commercial redistribution as well as modifications of the work as long as attribution is given to the authors and STEMedicine as the original publication source, and a link to the article on the STEMedicine website is provided.