Hyperuricaemia, chronic kidney disease, and outcomes in heart failure: Potential mechanistic insights from epidemiological data

Gerasimos S. Filippatos, Mustafa I. Ahmed, James D. Gladden, Marjan Mujib, Inmaculada B. Aban, Thomas E. Love, Paul W. Sanders, Bertram Pitt, Stefan D. Anker, Ali Ahmed

Research output: Contribution to journalArticlepeer-review

Abstract

Aim To determine if the association between hyperuricaemia and poor outcomes in heart failure (HF) varies by chronic kidney disease (CKD).Methods and resultsOf the 2645 systolic HF patients in the Beta-Blocker Evaluation of Survival Trial with data on baseline serum uric acid, 1422 had hyperuricaemia (uric acid 2). Hyperuricaemia-associated hazard ratios (HRs) and 95 confidence intervals (CI) for all-cause mortality and HF hospitalization were 1.44 (1.121.85, P 0.005) and 1.27 (1.021.58, P 0.031), respectively. Hazard ratios (95 CIs) for all-cause mortality among those with and without CKD were 0.96 (0.701.31, P 0.792) and 1.40 (1.081.82, P 0.011), respectively (P for interaction, 0.071), and those for HF hospitalization among those with and without CKD were 0.99 (0.741.33, P 0.942) and 1.49 (1.191.86, P 0.001), respectively (P for interaction, 0.033).Conclusion Hyperuricaemia has a significant association with poor outcomes in HF patients without CKD but not in those with CKD, suggesting that hyperuricaemia may predict poor outcomes when it is primarily a marker of increased xanthine oxidase activity, but not when it is primarily due to impaired renal excretion of uric acid.

Original languageEnglish
Pages (from-to)712-720
Number of pages9
JournalEuropean Heart Journal
Volume32
Issue number6
DOIs
Publication statusPublished - Mar 2011

Keywords

  • Chronic kidney disease
  • Heart failure
  • Hyperuricaemia
  • Outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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