Abstract
Background: To date uric acid (UA) is not considered a cardiovascular risk factor, although evidence about a relationship between UA and cardiovascular diseases has been reported. Methods: Information from 10,840 patients enrolled in the GISSI-Prevenzione trial was used to evaluate the relationship between UA and risk for total mortality and cardiovascular events (CVE). UA levels were categorized in quintiles, as ≤ 4.5 (Q1), 4.6 to 5.3 (Q2), 5.4 to 6.0 (Q3), 6.1 to 6.8 (Q4) and > 6.8 (Q5) mg/dL. Multivariable analysis was used to estimate the relative risks (HR) of outcome measures across categories of UA. The analysis of the area under the receiver operating characteristic curve (AUC), the net reclassification improvement (NRI), and the integrated discrimination improvement (IDI) tests were used to evaluate the incremental prognostic information of UA. Results: During 36,802 person-years of follow-up, 974 deaths and 1120 cardiovascular events occurred. We found a statistically significant association between high UA and total mortality [HR, P value]: Q1 [reference category, 1.00]; Q2 [1.13, 0.267]; Q3 [1.06, 0.619]; Q4 [1.23, 0.063]; Q5 [1.63, <0.0001], test for trend P <0.0001. Similar results were obtained for cardiovascular events [HR, P value]: Q1 [reference category, 1.00]; Q2 [1.12, 0.271]; Q3 [1.19, 0.094]; Q4 [1.25, 0.031]; Q5 [1.38, 0.002], test for trend P = 0.0009. The prognostic accuracy of prediction models for CVE was significantly increased by adding UA to classical cardiovascular risk factors (AUC P = 0.0041; NRI P = 0.0004; IDI P <0.0001). Conclusion: High UA may be considered a risk factor for death and CVE.
| Original language | English |
|---|---|
| Pages (from-to) | 262-269 |
| Number of pages | 8 |
| Journal | International Journal of Cardiology |
| Volume | 167 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jul 15 2013 |
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Keywords
- Cardiovascular diseases
- Coronary disease
- Prevention
- Risk factors
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Uric acid : A cardiovascular risk factor in patients with recent myocardial infarction. / Levantesi, Giacomo; Marfisi, Rosa Maria; Franzosi, Maria Grazia; Maggioni, Aldo Pietro; Nicolosi, Gian Luigi; Schweiger, Carlo; Silletta, Maria Giuseppina; Tavazzi, Luigi; Tognoni, Gianni; Marchioli, Roberto.
In: International Journal of Cardiology, Vol. 167, No. 1, 15.07.2013, p. 262-269.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Uric acid
T2 - A cardiovascular risk factor in patients with recent myocardial infarction
AU - Levantesi, Giacomo
AU - Marfisi, Rosa Maria
AU - Franzosi, Maria Grazia
AU - Maggioni, Aldo Pietro
AU - Nicolosi, Gian Luigi
AU - Schweiger, Carlo
AU - Silletta, Maria Giuseppina
AU - Tavazzi, Luigi
AU - Tognoni, Gianni
AU - Marchioli, Roberto
PY - 2013/7/15
Y1 - 2013/7/15
N2 - Background: To date uric acid (UA) is not considered a cardiovascular risk factor, although evidence about a relationship between UA and cardiovascular diseases has been reported. Methods: Information from 10,840 patients enrolled in the GISSI-Prevenzione trial was used to evaluate the relationship between UA and risk for total mortality and cardiovascular events (CVE). UA levels were categorized in quintiles, as ≤ 4.5 (Q1), 4.6 to 5.3 (Q2), 5.4 to 6.0 (Q3), 6.1 to 6.8 (Q4) and > 6.8 (Q5) mg/dL. Multivariable analysis was used to estimate the relative risks (HR) of outcome measures across categories of UA. The analysis of the area under the receiver operating characteristic curve (AUC), the net reclassification improvement (NRI), and the integrated discrimination improvement (IDI) tests were used to evaluate the incremental prognostic information of UA. Results: During 36,802 person-years of follow-up, 974 deaths and 1120 cardiovascular events occurred. We found a statistically significant association between high UA and total mortality [HR, P value]: Q1 [reference category, 1.00]; Q2 [1.13, 0.267]; Q3 [1.06, 0.619]; Q4 [1.23, 0.063]; Q5 [1.63, <0.0001], test for trend P <0.0001. Similar results were obtained for cardiovascular events [HR, P value]: Q1 [reference category, 1.00]; Q2 [1.12, 0.271]; Q3 [1.19, 0.094]; Q4 [1.25, 0.031]; Q5 [1.38, 0.002], test for trend P = 0.0009. The prognostic accuracy of prediction models for CVE was significantly increased by adding UA to classical cardiovascular risk factors (AUC P = 0.0041; NRI P = 0.0004; IDI P <0.0001). Conclusion: High UA may be considered a risk factor for death and CVE.
AB - Background: To date uric acid (UA) is not considered a cardiovascular risk factor, although evidence about a relationship between UA and cardiovascular diseases has been reported. Methods: Information from 10,840 patients enrolled in the GISSI-Prevenzione trial was used to evaluate the relationship between UA and risk for total mortality and cardiovascular events (CVE). UA levels were categorized in quintiles, as ≤ 4.5 (Q1), 4.6 to 5.3 (Q2), 5.4 to 6.0 (Q3), 6.1 to 6.8 (Q4) and > 6.8 (Q5) mg/dL. Multivariable analysis was used to estimate the relative risks (HR) of outcome measures across categories of UA. The analysis of the area under the receiver operating characteristic curve (AUC), the net reclassification improvement (NRI), and the integrated discrimination improvement (IDI) tests were used to evaluate the incremental prognostic information of UA. Results: During 36,802 person-years of follow-up, 974 deaths and 1120 cardiovascular events occurred. We found a statistically significant association between high UA and total mortality [HR, P value]: Q1 [reference category, 1.00]; Q2 [1.13, 0.267]; Q3 [1.06, 0.619]; Q4 [1.23, 0.063]; Q5 [1.63, <0.0001], test for trend P <0.0001. Similar results were obtained for cardiovascular events [HR, P value]: Q1 [reference category, 1.00]; Q2 [1.12, 0.271]; Q3 [1.19, 0.094]; Q4 [1.25, 0.031]; Q5 [1.38, 0.002], test for trend P = 0.0009. The prognostic accuracy of prediction models for CVE was significantly increased by adding UA to classical cardiovascular risk factors (AUC P = 0.0041; NRI P = 0.0004; IDI P <0.0001). Conclusion: High UA may be considered a risk factor for death and CVE.
KW - Cardiovascular diseases
KW - Coronary disease
KW - Prevention
KW - Risk factors
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UR - http://www.scopus.com/inward/citedby.url?scp=84878594838&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2011.12.110
DO - 10.1016/j.ijcard.2011.12.110
M3 - Article
C2 - 22261690
AN - SCOPUS:84878594838
VL - 167
SP - 262
EP - 269
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 1
ER -