Serum uric acid on admission predicts in-hospital mortality in patients with acute coronary syndrome

M Magnoni, M Berteotti, F Ceriotti, V Mallia, V Vergani, G Peretto, G Angeloni, N Cristell, Attilio Maseri, D Cianflone

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Abstract

Background Despite the association between uric acid and cardiovascular disease has been known for decades, the prognostic value of serum uric acid (UA) in all clinical manifestations of acute coronary syndrome (ACS), namely ST-elevation myocardial infarction (STEMI), NSTEMI and unstable angina, has not been definitively assessed. Methods This retrospective analysis included patients from previous SPAI and FAMI studies with the aim to investigate the association between serum uric acid and major adverse cardiovascular events at 180 days from hospital admission. Results 1548 patients were considered and di vided in four groups, according UA concentration. Uricemia was significantly associated with gender, BMI, arterial hypertension, HDL-cholesterol, triglycerides, metabolic syndrome and glomerular filtration rate in univariate analysis. Multivariate logistic regression indicated that UA >  6.0 mg/dL on admission increased the risk of in-hospital mortality in overall population (OR 2.9, 95%CI 1.4–6.1; p = 0.0057) and in patients with de novo ACS (OR 3.2, 95%CI 1.5–6.8; p = 0.0033). Comparable results were also obtained after adjusting the model for age, gender, body mass index, glomerular filtration rate, metabolic syndrome, acute revascularization and ethnicity. A positive correlation was observed between UA and C reactive protein concentrations in in-hospital deaths only (rho 0.41, p = 0.027). Conclusion In patients with acute coronary syndrome, uricemia levels above the current international reference limit (6.0 mg/dl) were associated with in-hospital mortality, independently from ethnicity and renal function. © 2017
Original languageEnglish
Pages (from-to)25-29
Number of pages5
JournalInternational Journal of Cardiology
Volume240
Issue number4
DOIs
Publication statusPublished - 2017

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Acute Coronary Syndrome
Hospital Mortality
Uric Acid
Serum
Glomerular Filtration Rate
Unstable Angina
C-Reactive Protein
HDL Cholesterol
Triglycerides
Body Mass Index
Cardiovascular Diseases
Logistic Models
Hypertension
Kidney
Population

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Serum uric acid on admission predicts in-hospital mortality in patients with acute coronary syndrome. / Magnoni, M; Berteotti, M; Ceriotti, F; Mallia, V; Vergani, V; Peretto, G; Angeloni, G; Cristell, N; Maseri, Attilio; Cianflone, D.

In: International Journal of Cardiology, Vol. 240, No. 4, 2017, p. 25-29.

Research output: Contribution to journalArticle

Magnoni, M ; Berteotti, M ; Ceriotti, F ; Mallia, V ; Vergani, V ; Peretto, G ; Angeloni, G ; Cristell, N ; Maseri, Attilio ; Cianflone, D. / Serum uric acid on admission predicts in-hospital mortality in patients with acute coronary syndrome. In: International Journal of Cardiology. 2017 ; Vol. 240, No. 4. pp. 25-29.
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abstract = "Background Despite the association between uric acid and cardiovascular disease has been known for decades, the prognostic value of serum uric acid (UA) in all clinical manifestations of acute coronary syndrome (ACS), namely ST-elevation myocardial infarction (STEMI), NSTEMI and unstable angina, has not been definitively assessed. Methods This retrospective analysis included patients from previous SPAI and FAMI studies with the aim to investigate the association between serum uric acid and major adverse cardiovascular events at 180 days from hospital admission. Results 1548 patients were considered and di vided in four groups, according UA concentration. Uricemia was significantly associated with gender, BMI, arterial hypertension, HDL-cholesterol, triglycerides, metabolic syndrome and glomerular filtration rate in univariate analysis. Multivariate logistic regression indicated that UA >  6.0 mg/dL on admission increased the risk of in-hospital mortality in overall population (OR 2.9, 95{\%}CI 1.4–6.1; p = 0.0057) and in patients with de novo ACS (OR 3.2, 95{\%}CI 1.5–6.8; p = 0.0033). Comparable results were also obtained after adjusting the model for age, gender, body mass index, glomerular filtration rate, metabolic syndrome, acute revascularization and ethnicity. A positive correlation was observed between UA and C reactive protein concentrations in in-hospital deaths only (rho 0.41, p = 0.027). Conclusion In patients with acute coronary syndrome, uricemia levels above the current international reference limit (6.0 mg/dl) were associated with in-hospital mortality, independently from ethnicity and renal function. {\circledC} 2017",
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AU - Angeloni, G

AU - Cristell, N

AU - Maseri, Attilio

AU - Cianflone, D

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N2 - Background Despite the association between uric acid and cardiovascular disease has been known for decades, the prognostic value of serum uric acid (UA) in all clinical manifestations of acute coronary syndrome (ACS), namely ST-elevation myocardial infarction (STEMI), NSTEMI and unstable angina, has not been definitively assessed. Methods This retrospective analysis included patients from previous SPAI and FAMI studies with the aim to investigate the association between serum uric acid and major adverse cardiovascular events at 180 days from hospital admission. Results 1548 patients were considered and di vided in four groups, according UA concentration. Uricemia was significantly associated with gender, BMI, arterial hypertension, HDL-cholesterol, triglycerides, metabolic syndrome and glomerular filtration rate in univariate analysis. Multivariate logistic regression indicated that UA >  6.0 mg/dL on admission increased the risk of in-hospital mortality in overall population (OR 2.9, 95%CI 1.4–6.1; p = 0.0057) and in patients with de novo ACS (OR 3.2, 95%CI 1.5–6.8; p = 0.0033). Comparable results were also obtained after adjusting the model for age, gender, body mass index, glomerular filtration rate, metabolic syndrome, acute revascularization and ethnicity. A positive correlation was observed between UA and C reactive protein concentrations in in-hospital deaths only (rho 0.41, p = 0.027). Conclusion In patients with acute coronary syndrome, uricemia levels above the current international reference limit (6.0 mg/dl) were associated with in-hospital mortality, independently from ethnicity and renal function. © 2017

AB - Background Despite the association between uric acid and cardiovascular disease has been known for decades, the prognostic value of serum uric acid (UA) in all clinical manifestations of acute coronary syndrome (ACS), namely ST-elevation myocardial infarction (STEMI), NSTEMI and unstable angina, has not been definitively assessed. Methods This retrospective analysis included patients from previous SPAI and FAMI studies with the aim to investigate the association between serum uric acid and major adverse cardiovascular events at 180 days from hospital admission. Results 1548 patients were considered and di vided in four groups, according UA concentration. Uricemia was significantly associated with gender, BMI, arterial hypertension, HDL-cholesterol, triglycerides, metabolic syndrome and glomerular filtration rate in univariate analysis. Multivariate logistic regression indicated that UA >  6.0 mg/dL on admission increased the risk of in-hospital mortality in overall population (OR 2.9, 95%CI 1.4–6.1; p = 0.0057) and in patients with de novo ACS (OR 3.2, 95%CI 1.5–6.8; p = 0.0033). Comparable results were also obtained after adjusting the model for age, gender, body mass index, glomerular filtration rate, metabolic syndrome, acute revascularization and ethnicity. A positive correlation was observed between UA and C reactive protein concentrations in in-hospital deaths only (rho 0.41, p = 0.027). Conclusion In patients with acute coronary syndrome, uricemia levels above the current international reference limit (6.0 mg/dl) were associated with in-hospital mortality, independently from ethnicity and renal function. © 2017

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