Abstract
Aims. Mild renal impairment (estimated GFR 60-89 ml/min/1.73 m2) is a strong independent risk factor for mortality in ST-elevation myocardial infarction (STEMI), and is submitted to mechanical revascularization. Patients with renal impairment have decreased excretion of uric acid (UA) and they are thus particularly prone to have elevated serum UA concentrations. This study was aimed at assessing the association between increased UA and mortality in STEMI patients with mild renal impairment. Methods. We prospectively assessed, in 578 STEMI patients with mild renal impairment, whether elevated UA levels are associated with increased mortality both in the short term and in the long term. Results. Patients in the highest UA tertile showed a higher incidence of Killip class III-IV (p = 0.003) and lower values of ejection fraction (EF) (p <0.001). Lower values for estimated glomerular filtration rate (eGFR) at admission, nadir, and discharge were detected in the highest UA tertile, together with the highest values of peak troponin I (Tn I) (p = 0.002), and NT-proBrain Natriuretic Peptide [NT-proBNP] (p <0.001). No difference was found in mortality rates (both during their stay in the intensive cardiac care unit [ICCU], and at the 1-year post-discharge follow-up) among the UA tertiles. Conclusions. The UA levels seem to serve as markers of the severity of coronary artery disease, since they identify a subset of patients characterized by an advanced age, more hemodynamic derangement, and reduced renal function. However, neither short nor long-term mortality was affected.
| Original language | English |
|---|---|
| Pages (from-to) | 14-19 |
| Number of pages | 6 |
| Journal | Scandinavian Cardiovascular Journal |
| Volume | 49 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 1 2015 |
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Keywords
- Mild renal impairment
- PCI
- Prognosis
- ST-elevation myocardial infarction
- Uric acid
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Uric acid and mild renal impairment in patients with ST-elevation myocardial infarction. / Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Spini, Valentina; Angelotti, Paola; Gensini, Gian Franco.
In: Scandinavian Cardiovascular Journal, Vol. 49, No. 1, 01.02.2015, p. 14-19.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Uric acid and mild renal impairment in patients with ST-elevation myocardial infarction
AU - Lazzeri, Chiara
AU - Valente, Serafina
AU - Chiostri, Marco
AU - Spini, Valentina
AU - Angelotti, Paola
AU - Gensini, Gian Franco
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Aims. Mild renal impairment (estimated GFR 60-89 ml/min/1.73 m2) is a strong independent risk factor for mortality in ST-elevation myocardial infarction (STEMI), and is submitted to mechanical revascularization. Patients with renal impairment have decreased excretion of uric acid (UA) and they are thus particularly prone to have elevated serum UA concentrations. This study was aimed at assessing the association between increased UA and mortality in STEMI patients with mild renal impairment. Methods. We prospectively assessed, in 578 STEMI patients with mild renal impairment, whether elevated UA levels are associated with increased mortality both in the short term and in the long term. Results. Patients in the highest UA tertile showed a higher incidence of Killip class III-IV (p = 0.003) and lower values of ejection fraction (EF) (p <0.001). Lower values for estimated glomerular filtration rate (eGFR) at admission, nadir, and discharge were detected in the highest UA tertile, together with the highest values of peak troponin I (Tn I) (p = 0.002), and NT-proBrain Natriuretic Peptide [NT-proBNP] (p <0.001). No difference was found in mortality rates (both during their stay in the intensive cardiac care unit [ICCU], and at the 1-year post-discharge follow-up) among the UA tertiles. Conclusions. The UA levels seem to serve as markers of the severity of coronary artery disease, since they identify a subset of patients characterized by an advanced age, more hemodynamic derangement, and reduced renal function. However, neither short nor long-term mortality was affected.
AB - Aims. Mild renal impairment (estimated GFR 60-89 ml/min/1.73 m2) is a strong independent risk factor for mortality in ST-elevation myocardial infarction (STEMI), and is submitted to mechanical revascularization. Patients with renal impairment have decreased excretion of uric acid (UA) and they are thus particularly prone to have elevated serum UA concentrations. This study was aimed at assessing the association between increased UA and mortality in STEMI patients with mild renal impairment. Methods. We prospectively assessed, in 578 STEMI patients with mild renal impairment, whether elevated UA levels are associated with increased mortality both in the short term and in the long term. Results. Patients in the highest UA tertile showed a higher incidence of Killip class III-IV (p = 0.003) and lower values of ejection fraction (EF) (p <0.001). Lower values for estimated glomerular filtration rate (eGFR) at admission, nadir, and discharge were detected in the highest UA tertile, together with the highest values of peak troponin I (Tn I) (p = 0.002), and NT-proBrain Natriuretic Peptide [NT-proBNP] (p <0.001). No difference was found in mortality rates (both during their stay in the intensive cardiac care unit [ICCU], and at the 1-year post-discharge follow-up) among the UA tertiles. Conclusions. The UA levels seem to serve as markers of the severity of coronary artery disease, since they identify a subset of patients characterized by an advanced age, more hemodynamic derangement, and reduced renal function. However, neither short nor long-term mortality was affected.
KW - Mild renal impairment
KW - PCI
KW - Prognosis
KW - ST-elevation myocardial infarction
KW - Uric acid
UR - http://www.scopus.com/inward/record.url?scp=84923372597&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84923372597&partnerID=8YFLogxK
U2 - 10.3109/14017431.2015.1005662
DO - 10.3109/14017431.2015.1005662
M3 - Article
C2 - 25659042
AN - SCOPUS:84923372597
VL - 49
SP - 14
EP - 19
JO - Scandinavian Cardiovascular Journal
JF - Scandinavian Cardiovascular Journal
SN - 1401-7431
IS - 1
ER -