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Serum uric acid level predicts adverse outcomes after myocardial revascularization or cardiac valve surgery.
- Source :
-
European journal of preventive cardiology [Eur J Prev Cardiol] 2018 Jan; Vol. 25 (2), pp. 119-126. Date of Electronic Publication: 2017 Nov 22. - Publication Year :
- 2018
-
Abstract
- Background High levels of serum uric acid have been associated with adverse outcomes in cardiovascular diseases such as myocardial infarction and heart failure. The aim of the current study was to evaluate the prognostic role of serum uric acid levels in patients undergoing cardiac rehabilitation after myocardial revascularization and/or cardiac valve surgery. Design We performed an observational prospective cohort study. Methods The study included 1440 patients with available serum uric acid levels, prospectively followed for 50 ± 17 months. Mean age was 67 ± 11 years; 781 patients (54%) underwent myocardial revascularization, 474 (33%) cardiac valve surgery and 185 (13%) valve-plus-coronary artery by-pass graft surgery. The primary endpoints were overall and cardiovascular mortality while secondary end-points were combined major adverse cardiac and cerebrovascular events. Results Serum uric acid level mean values were 286 ± 95 µmol/l and elevated serum uric acid levels (≥360 µmol/l or 6 mg/dl) were found in 275 patients (19%). Overall mortality (hazard ratio = 2.1; 95% confidence interval: 1.5-3.0; p < 0.001), cardiovascular mortality (hazard ratio = 2.0; 95% confidence interval: 1.2-3.2; p = 0.004) and major adverse cardiac and cerebrovascular events rate (hazard ratio = 1.5; 95% confidence interval: 1.0-2.0; p = 0.019) were significantly higher in patients with elevated serum uric acid levels, even after adjustment for age, gender, arterial hypertension, diabetes, glomerular filtration rate, atrial fibrillation and medical therapy. Moreover, strong positive correlations between serum uric acid level and probability of overall mortality ( p < 0.001), cardiovascular mortality ( p < 0.001) and major adverse cardiac and cerebrovascular events ( p = 0.003) were found. Conclusions Serum uric acid levels predict mortality and adverse cardiovascular outcome in patients undergoing myocardial revascularization and/or cardiac valve surgery even after the adjustment for age, gender, arterial hypertension, diabetes, glomerular filtration rate and medical therapy.
- Subjects :
- Age Factors
Aged
Biomarkers blood
Cardiac Rehabilitation
Comorbidity
Coronary Artery Bypass mortality
Coronary Artery Bypass rehabilitation
Coronary Artery Disease diagnosis
Coronary Artery Disease mortality
Female
Heart Valve Diseases diagnosis
Heart Valve Diseases mortality
Heart Valve Prosthesis Implantation mortality
Heart Valve Prosthesis Implantation rehabilitation
Humans
Hyperuricemia diagnosis
Hyperuricemia mortality
Italy epidemiology
Male
Middle Aged
Postoperative Complications diagnosis
Postoperative Complications mortality
Prospective Studies
Registries
Risk Assessment
Risk Factors
Sex Factors
Time Factors
Treatment Outcome
Coronary Artery Bypass adverse effects
Coronary Artery Disease surgery
Heart Valve Diseases surgery
Heart Valve Prosthesis Implantation adverse effects
Hyperuricemia blood
Postoperative Complications epidemiology
Uric Acid blood
Subjects
Details
- Language :
- English
- ISSN :
- 2047-4881
- Volume :
- 25
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- European journal of preventive cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 29164926
- Full Text :
- https://doi.org/10.1177/2047487317744045