scholarly journals Daily Coffee Drinking Is Associated with Lower Risks of Cardiovascular and Total Mortality in a General Italian Population: Results from the Moli-sani Study

2020 ◽  
Author(s):  
Emilia Ruggiero ◽  
Augusto Di Castelnuovo ◽  
Simona Costanzo ◽  
Mariarosaria Persichillo ◽  
Amalia De Curtis ◽  
...  
Keyword(s):  
Troponin I ◽  
Cox Regression ◽  
Coffee Consumption ◽  
Total Mortality ◽  
Relative Reduction ◽  
Italian Population ◽  
Coffee Intake ◽  
Mediterranean Countries ◽  
All Cause Mortality ◽  
Cvd Mortality

ABSTRACT Background An inverse relationship between coffee intake and mortality has been observed in several population cohorts, but rarely within Mediterranean countries. Moreover, the biological pathways mediating such an association remain unclear. Objectives We assessed the associations between coffee consumption and total and cause-specific mortality and examined the mediating roles of N-terminal pro B–type natriuretic peptide (NTproBNP), high-sensitivity Troponin I, blood glucose, lipid metabolism, and selected biomarkers of inflammation and renal function. Methods We longitudinally analyzed data on 20,487 men and women (35–94 years old at baseline) in the Moli-sani Study, a prospective cohort established in 2005–2010. Individuals were free from cardiovascular disease (CVD) and cancer and were followed-up for a median of 8.3 years. Dietary data were collected by a 188-item semi-quantitative FFQ. Coffee intake was standardized to a 30-mL Italian espresso cup size. HRs with 95% CIs were calculated by multivariable Cox regression. Results In comparison with no/rare coffee consumption (up to 1 cup/d), HRs for all-cause mortality across categories of coffee consumption (>1 to ≤2, >2 to ≤3, >3 to ≤4 and >4 cups/d) were 0.79 (95% CI, 0.65–0.95), 0.84 (95% CI, 0.69–1.03), 0.72 (95% CI, 0.57–0.92), and 0.85 (95% CI, 0.62–1.12), respectively. For CVD mortality, a nonlinear (P for non-linearity = 0.021) J-shaped association was found (magnitude of the relative reduction = 37%; nadir at 3–4 cups/d). Circulating levels of NTproBNP explained up to 26.4% of the association between coffee and all-cause mortality, while systolic blood pressure was likely to be on the pathway between coffee and CVD mortality, although to a lesser extent. Conclusions In this large cohort of Italian adults, moderate consumption (3–4 cups/d) of Italian-style coffee was associated with lower risks of all-cause and, specifically, of CVD mortality. Among the known biomarkers investigated here, NTproBNP likely mediates the relationship between coffee intake and all-cause mortality.

scholarly journals Coffee consumption and total mortality in a Mediterranean prospective cohort

2018 ◽  
Vol 108 (5) ◽  
pp. 1113-1120 ◽  
Author(s):  
Adela M Navarro ◽  
Miguel Á Martinez-Gonzalez ◽  
Alfredo Gea ◽  
Giuseppe Grosso ◽  
José M Martín-Moreno ◽  
...  
Keyword(s):  
Regression Models ◽  
Cox Regression ◽  
Coffee Consumption ◽  
Total Mortality ◽  
Potential Effect ◽  
National Death Index ◽  
Food Frequency ◽  
Highly Educated ◽  
All Cause Mortality

ABSTRACT Background The relation of coffee consumption with total mortality is controversial, because the available evidence is still inconsistent. Objective This study aimed to assess this association in a highly educated, middle-aged Mediterranean cohort. Design We analyzed data from 201,055 person-years of follow-up arising from 19,888 participants. Coffee consumption was obtained at baseline with the use of a previously validated semiquantitative food-frequency questionnaire. Information on mortality was ascertained by permanent contact with the “Seguimiento Universidad de Navarra” (SUN) participants and their families, postal authorities, and consultation of the National Death Index. We used Cox regression models to estimate HRs and 95% CIs for mortality according to baseline total coffee consumption adjusted for potential confounders. Sex, age, and baseline adherence to the Mediterranean diet were considered as potential effect modifiers. Results Among the 19,888 participants, 337 died. Overall, in the multivariable adjusted analysis, we found a 22% lower risk of all-cause mortality for each 2 additional cups of total coffee per day (HR: 0.78; 95% CI: 0.66, 0.93). This association was stronger for participants aged ≥55 y (HR: 0.67; 95% CI: 0.52, 0.86) than for younger participants, who showed no significant association (P-interaction = 0.002). Conclusion In a Mediterranean cohort, we found an inverse linear association between total coffee consumption and the risk of all-cause mortality that was strongest among participants older than 54 y.

scholarly journals White cell counts in relation to mortality in a general population of cohort study in the Netherlands: a mediating effect or not?

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030949 ◽  
Author(s):  
Itziar Abete ◽  
Yunxia Lu ◽  
Camille Lassale ◽  
Monique Verschuren ◽  
Yvonne van der Schouw ◽  
...  
Keyword(s):  
Cox Regression ◽  
White Cell Count ◽  
Total Mortality ◽  
White Cell ◽  
Mediating Effect ◽  
Cell Counts ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Death Cases ◽  
Cvd Mortality

BackgroundWhite cell count (WCC) is a clinical marker of inflammation. Data are limited regarding the association of total and differential WCC with risk of mortality, and its role related with smoking and body mass index (BMI).MethodsA total of 14 433 participants (4150 men; 10 283 women; average age 47.3±11.8 years) from the Dutch European Prospective Investigation into Cancer and Nutrition-Netherlands cohort were included. The associations between prediagnostic total WCC and its subtypes and risk of all-cause, cancer and cardiovascular disease (CVD) mortality were assessed. The role of WCC related with smoking and BMI on mortality was further explored. Multivariate Cox regression models were performed to estimate the HR and 95% CI.ResultsAfter an average follow-up of 15.8 years, a total of 936 death cases were identified (466 cancer; 179 CVD; 291 other causes). Statistically significant graded associations between total WCC, and counts of lymphocytes, monocytes, neutrophils and eosinophils and risk of total mortality were observed. These associations were more apparent in current smokers. Strong associations for all-cause mortality or cancer mortality were observed in subjects with BMI ≥25 kg/m2, ever smoking and elevated WCC (HR 3.92, 95% CI 2.76 to 5.57; HR 3.93, 95% CI 2.30 to 6.72). WCC partly mediated the associations between smoking or BMI and all-cause mortality.ConclusionsPrediagnostic WCC and its subtypes are associated with all-cause, cancer and CVD mortality risk. It may play a partially mediate role on the association between smoking or obesity and mortality.

P1566Identification of the cardiovascular threshold limit for serum uric acid. Analysis from a general Italian population

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Virdis ◽  
E Casiglia ◽  
S Masi ◽  
G Desideri ◽  
V Tikhonoff ◽  
...  
Keyword(s):  
Uric Acid ◽  
Clinical Practice ◽  
Serum Uric Acid ◽  
Mortality Risk ◽  
Cox Regression ◽  
Total Mortality ◽  
Italian Population ◽  
Increased Risk ◽  
Myocardial Infraction ◽  
Cvd Mortality

Abstract Background Serum uric acid (SUA) is increasingly recognised as an important predictor of cardiovascular disease (CVD) and total mortality. However, the levels of SUA that discriminate across the different strata of risk for CVD and total mortality remain unknown, complicating the identification of subjects at high or low mortality risk for SUA in clinical practice. Purpose In this study we used a large Italian population comprising >3ehz748.0326 subjects to assess the threshold of SUA that increases the risk of total and CVD mortality. Methods The URic Acid Right for heArt Health (URRAH) study is a regional-basis multicentre cohort study which collected data from prospective studies and databases from different hypertension centres, including subjects with at least one measure of SUA and a follow-up of about 20 years. Total mortality was defined as mortality for any causes, cardiovascular mortality as death due to fatal myocardial infraction, stroke or heart failure. Multivariate dichotomic logistic and Cox regression models were used to confirm the relationship between SUA and mortality status both from cardiovascular and any causes, while ROC curves were used to identify the threshold of SUA that better discriminated people at higher or lower mortality risk. Results A total of 22.275 subjects had SUA and mortality information. Logistic regression identified a direct and strong association between SUA and an increased risk of total (OR 1.176, 95% CI 1.127–1.227) and CVD (OR 1.147, 95% CI 1.093–1.203) mortality, independently of other CVD risk factors (age, BMI, LDL cholesterol, diagnosis of diabetes, hypertension, chronic kidney disease, alcohol consumption and smoking). Cox models confirmed the presence of an independent association between SUA and any causes (HR 1.123, 95% CI 1.090–1.567) and CVD (HR 1.124, 95% CI 1.081–1.169) mortality. ROC curve analysis identified a cut-off value od SUA [(4.79 mg/dL (95% CI 4.7–5.4 mg/dl)] able to discriminate total mortality status, and a different one [(5.60 mg/dL (95% CI 5.09–5.89 mg/dl)] able to identify CVD mortality status. Multivariate Cox analysis adjusted for confounders confirmed that subjects with SUA >4.79 mg/dl had a significantly higher total mortality (HR 1.293, 95% CI 1.181–1.416) compared to those with SUA <4.79 mg/dl, independently of covariables. Similarly, subjects with SUA >5.60 mg/dl had a significantly higher CVD mortality (HR 1.428, 95% CI 1.273–1.600) than those with SUA <5.60 mg/dl after adjustment for the same confounders. Conclusion Levels of SUA that increase the risk of total and CVD mortality are significantly lower than those commonly used for the definition of hyperuricemia in clinical practice. Our data provide the first large evidence of a level of “cardiovascular” SUA that might be used in clinical practice to identify subjects at greater risk of total and CVD mortality.

scholarly journals Coffee consumption and risk of renal cell carcinoma in the NIH-AARP Diet and Health Study

2021 ◽  
Author(s):  
Jongeun Rhee ◽  
Erikka Loftfield ◽  
Neal D Freedman ◽  
Linda M Liao ◽  
Rashmi Sinha ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Cox Regression ◽  
Coffee Consumption ◽  
Health Study ◽  
Coffee Intake ◽  
Decaffeinated Coffee ◽  
Incident Cases ◽  
Reduced Risk

Abstract Background Coffee consumption has been associated with a reduced risk of some cancers, but the evidence for renal cell carcinoma (RCC) is inconclusive. We investigated the relationship between coffee and RCC within a large cohort. Methods Coffee intake was assessed at baseline in the National Institutes of Health–American Association of Retired Persons Diet and Health Study. Among 420 118 participants eligible for analysis, 2674 incident cases were identified. We fitted Cox-regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for coffee consumption vs non-drinkers. Results We observed HRs of 0.94 (95% CI 0.81, 1.09), 0.94 (0.81, 1.09), 0.80 (0.70, 0.92) and 0.77 (0.66, 0.90) for usual coffee intake of &lt;1, 1, 2–3 and ≥4 cups/day, respectively (Ptrend = 0.00003). This relationship was observed among never-smokers (≥4 cups/day: HR 0.62, 95% CI 0.46, 0.83; Ptrend = 0.000003) but not ever-smokers (HR 0.85, 95% CI 0.70, 1.05; Ptrend = 0.35; Pinteraction = 0.0009) and remained in analyses restricted to cases diagnosed &gt;10 years after baseline (HR 0.65, 95% CI 0.51, 0.82; Ptrend = 0.0005). Associations were similar between subgroups who drank predominately caffeinated or decaffeinated coffee (Pinteraction = 0.74). Conclusion In this investigation of coffee and RCC, to our knowledge the largest to date, we observed a 20% reduced risk for intake of ≥2 cups/day vs not drinking. Our findings add RCC to the growing list of cancers for which coffee consumption may be protective.

scholarly journals Dietary patterns related to total mortality and cancer mortality in the United States

2021 ◽  
Author(s):  
Marcela R. Entwistle ◽  
Donald Schweizer ◽  
Ricardo Cisneros
Keyword(s):  
United States ◽  
Dietary Patterns ◽  
Cancer Mortality ◽  
Cox Regression ◽  
Total Mortality ◽  
Principal Component ◽  
The United States ◽  
Red Meat ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Purpose This study investigated the association between dietary patterns, total mortality, and cancer mortality in the United States. Methods We identified the four major dietary patterns at baseline from 13,466 participants of the NHANES III cohort using principal component analysis (PCA). Dietary patterns were categorized into ‘prudent’ (fruits and vegetables), ‘western’ (red meat, sweets, pastries, oils), ‘traditional’ (red meat, legumes, potatoes, bread), and ‘fish and alcohol’. We estimated hazard ratios for total mortality, and cancer mortality using Cox regression models. Results A total of 4,963 deaths were documented after a mean follow-up of 19.59 years. Higher adherence to the ‘prudent’ pattern was associated with the lowest risk of total mortality (5th vs. 1st quintile HR 0.90, 95% CI 0.82–0.98), with evidence that all-cause mortality decreased as consumption of the pattern increased. No evidence was found that the ‘prudent’ pattern reduced cancer mortality. The ‘western’ and the ‘traditional’ patterns were associated with up to 22% and 16% increased risk for total mortality (5th vs. 1st quintile HR 1.22, 95% CI 1.11–1.34; and 5th vs. 1st quintile HR 1.16, 95% CI 1.06–1.27, respectively), and up to 33% and 15% increased risk for cancer mortality (5th vs. 1st quintile HR 1.33, 95% CI 1.10–1.62; and 5th vs. 1st quintile HR 1.15, 95% CI 1.06–1.24, respectively). The associations between adherence to the ‘fish and alcohol’ pattern and total mortality, and cancer mortality were not statistically significant. Conclusion Higher adherence to the ‘prudent’ diet decreased the risk of all-cause mortality but did not affect cancer mortality. Greater adherence to the ‘western’ and ‘traditional’ diet increased the risk of total mortality and mortality due to cancer.

Association between selenium intake, diabetes, and mortality in adults: findings from National Health and Nutrition Examination Survey (NHANES) 2003-2014

2021 ◽  
pp. 1-24
Author(s):  
Bushra Hoque ◽  
Zumin Shi
Keyword(s):  
National Health ◽  
Cox Regression ◽  
Inverse Association ◽  
Nutrition Examination Survey ◽  
Health And Nutrition ◽  
Hazard Ratios ◽  
The Us ◽  
All Cause Mortality ◽  
Cvd Mortality

Abstract Selenium (Se) is a trace mineral that has antioxidant and anti-inflammatory properties. This study aimed to investigate the association between Se intake, diabetes, all-cause and cause-specific mortality in a representative sample of US adults. Data from 18,932 adults who attended the 2003-2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Information on mortality was obtained from the US mortality registry updated to 2015. Multivariable logistic regression and Cox regression were used. Cross-sectionally, Se intake was positively associated with diabetes. Comparing extreme quartiles of Se intake, the odds ratio (OR) for diabetes was 1.44 (95% CI: 1.09–1.89). During a mean of 6.6 years follow-up, there were 1627 death (312 CVD, 386 cancer). High intake of Se was associated with a lower risk of all-cause mortality. When comparing the highest with the lowest quartiles of Se intake, the hazard ratios (HRs) for all-cause, CVD mortality, cancer mortality and other mortality were: 0.77 (95% CI 0.59-1.01), 0.62 (95% CI, 0.35-1.13), 1.42 (95% CI, 0.78-2.58) and 0.60 (95% CI,0.40-0.80), respectively. The inverse association between Se intake and all-cause mortality was only found among white participants. In conclusion, Se intake was positively associated with diabetes but inversely associated with all-cause mortality. There was no interaction between Se intake and diabetes in relation to all-cause mortality.

P1885Cha2ds-2vasc score lacks of ability to predict mortality in patients attending the emergency department with atrial fibrillation in the presence of troponin i

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M I Gonzalez Del Hoyo ◽  
G Cediel ◽  
A Carrasquer ◽  
G Bonet ◽  
K Vasquez-Nunez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Emergency Department ◽  
Regression Analysis ◽  
Troponin I ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Abstract Background CHA2DS2-VASc score has been used as a surrogate marker for predicting outcomes beyond thromboembolic risk in patients with atrial fibrillation (AF). Likewise, cardiac troponin I (cTnI) is a predictor of mortality in AF. Purpose This study aimed to investigate the association of cTnI and CHA2DS2-VASc score with long-term prognosis in patients admitted to the emergency department with AF. Methods A retrospective cohort study conducted between January 2012 and December 2013, enrolling patients admitted to the emergency department with AF and having documented cTnI measurements. CHA2DS2-VASc score was estimated. Primary endpoint was 5-year all-cause mortality, readmission for heart failure (HF), readmission for myocardial infarction (MI) and the composite end point of major adverse cardiac events defined as death, readmission for HF or readmission for MI (MACE). Results A total of 578 patients with AF were studied, of whom 252 patients had elevated levels of cTnI (43.6%) and 334 patients had CHA2DS2-VASc score >3 (57.8%). Patients with elevated cTnI tended to be oldercompared with those who did not have cTnI elevation and were more frequently comorbid and of higher ischemic risk, including hypertension, prior MI, prior HF, chronic renal failure and peripheral artery disease. The overall median CHA2DS2-VASc score was higher in those with cTnI elevation compared to those patients elevated cTnI levels (4.2 vs 3.3 points, p<0.001). Main diagnoses at hospital discharge were tachyarrhythmia 30.3%, followed by heart failure 17.7%, respiratory infections 9.5% and acute coronary syndrome 7.3%. At 5-year follow-up, all-cause death was significantly higher for patients with cTnI elevation compared with those who did not have cTnI elevation (56.4% vs. 27%; logrank test p<0.001). Specifically, for readmissions for HF and readmissions for MI there were no differences in between patients with or without cTnI elevation. In addition, MACE was reached in 165 patients (65.5%) with cTnI elevation, compare to 126 patients (38.7%) without cTnI elevation (p<0.001). On multivariable Cox regression analysis, cTnI elevation was an independent predictor of all-cause death (hazard ratio, 1.67, 95% confidence interval [CI]: 1.24–2.26, p=0.001) and of MACE (hazard ratio 1.47, 95% confidence interval 1.15–1.88; P=0.002), but it did not reach statistical significance for readmissions for MI and readmissions for HF. CHA2DS2-VASc score was a predictor on univariate Cox regression analysis for each endpoint, but it did not reach significance on multivariable Cox regression analysis for any endpoint. Conclusions cTnI is independently associated with long-term all-cause mortality in patients attending the emergency department with AF. cTnI compared to CHA2DS2-VASc score is thus a biomarker with predictive capacity for mortality in late follow-up, conferring utility in the risk stratification of patients with atrial fibrillation.

Prognostic Significance of Fragmented QRS in Patients with Hypertrophic Cardiomyopathy

Cardiology ◽  
2017 ◽  
Vol 138 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Xili Lu ◽  
Wei Wang ◽  
Ling Zhu ◽  
Yilu Wang ◽  
Kai Sun ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Cox Regression Analysis ◽  
Fragmented Qrs ◽  
All Cause Mortality ◽  
The Relationship ◽  
Cvd Mortality

Objectives: The relationship between a fragmented QRS (fQRS) and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aimed to investigate the prognostic significance of fQRS in patients with HCM. Methods: Between 2000 and 2012, 326 unrelated patients with HCM (72% male with a mean age of 52 years) were included and were divided into 2 groups: those with fQRS and those without fQRS. Results: A total of 105/326(32.2%) patients with HCM presented with fQRS at enrollment. During a follow-up of 5.3 ± 2.4 years, 33 patients died, 30 of cardiovascular disease (CVD). Cox regression analysis revealed that fQRS predicted a higher risk of all-cause mortality (adjusted hazard ratio [HR] 2.24; 95% confidence interval [CI] 1.08-4.64; p = 0.030) and CVD mortality (adjusted HR 2.68; 95% CI 1.22-5.91; p = 0.014). Our study also showed that fQRS increased the risk of heart failure-related death (adjusted HR 3.75; 95% CI 1.24-11.30; p = 0.019). Conclusions: Our results indicate that fQRS is associated with adverse clinical outcomes in patients with HCM.

scholarly journals Changes in waist circumference and risk of all-cause and CVD mortality: results from the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Angela A. Mulligan ◽  
Marleen A. H. Lentjes ◽  
Robert N. Luben ◽  
Nicholas J. Wareham ◽  
Kay-Tee Khaw
Keyword(s):  
Weight Loss ◽  
Waist Circumference ◽  
Mortality Risk ◽  
Total Mortality ◽  
Later Life ◽  
Central Adiposity ◽  
Men And Women ◽  
All Cause Mortality ◽  
Cvd Mortality ◽  
Prospective Investigation

Abstract Background Measures of abdominal adiposity are strongly associated with all-cause mortality and cardiovascular disease (CVD). However, data are limited and conflicting regarding the consequences of changes in body fat distribution. The main aims of this paper are to investigate the association between changes in waist circumference (WC) and all-cause and CVD mortality and to examine these changes in relation to concurrent changes in weight. Methods The European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study recruited 25,639 participants between 1993 and 1997, aged 39–79, a number of whom also attended a second examination (1998–2000), and were followed up to 2016 for mortality. Participants were eligible for inclusion if they had WC, weight and height measurements at both time-points; those with a self-reported history of CVD or cancer, body mass index < 18.5 kg/m2 or missing data on covariates were excluded, leaving 12,337 participants for analyses. The median (IQR) follow-up time was 16.4 (15.7, 17.2) years. Hazard Ratios (HRs) for all-cause (2866 deaths) and CVD mortality (822 deaths), by categories of WC change, were determined using Cox proportional hazards analyses. Results After multivariable adjustment, the HRs (95% CIs) for all-cause mortality for men and women with a WC gain (WCG) >  5 cm were 1.51 (1.29–1.75) and 1.25 (1.06–1.46) respectively. For CVD mortality in men and women with a WCG >  5 cm, the HRs were 1.84 (1.39–2.43) and 1.15 (0.85–1.55) respectively. In analyses of concurrent changes in WC and weight, the greatest risk (HRs) (95% CIs) in men occurred with weight loss and WCG: 1.80 (1.13–2.86) for all-cause and 2.22 (1.03–4.82) for CVD mortality. In women, the greatest risk for both all-cause (HR 1.50 (1.16–1.95)) and CVD mortality (HR 1.81 (1.15–2.85)) was observed in those with weight loss and maintenance of WC (WCM). Conclusions Objectively measured WCG > 5 cm, was associated with subsequent higher total mortality risk and higher CVD mortality risk in men. Interventions focusing on preventing increase in central adiposity rather than lowering weight per se in later life may potentially have greater health benefits.

scholarly journals Serum Uric Acid Revealed a U-Shaped Relationship With All-Cause Mortality and Cardiovascular Mortality in High Atherosclerosis Risk Patients: The ASSURE Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Yan Cang ◽  
Shaojie Xu ◽  
Jingyin Zhang ◽  
Jingyi Ju ◽  
Zijun Chen ◽  
...  
Keyword(s):  
Uric Acid ◽  
Regression Model ◽  
Serum Uric Acid ◽  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Multicenter Cohort Study ◽  
Male And Female ◽  
Cox Regression Analysis ◽  
All Cause Mortality ◽  
Cvd Mortality

Background: Previous studies have demonstrated an association between hyperuricemia and cardiovascular disease (CVD). The Framingham study confirmed that patients with high atherosclerotic risks (HARs) had worse prognoses. However, after adjusting for confounding factors, the association between serum uric acid (SUA) and all-cause mortality and cardiovascular mortality remains unclear, especially for HAR patients.Objective: The aim of this study was to reveal the relationship of SUA with all-cause and cardiovascular mortality in HAR patients.Methods: This multicenter cohort study enrolled 3,047 participants, and the follow-up was 68.85 ± 11.37 months. Factors related to cardiovascular and all-cause mortality were tested by multivariate Cox regression analysis. Restricted cubic splines (RCSs) with knots were used to explore the shape of the dose–response relationship with SUA and the hazard ratio (HR) of all-cause and CVD mortality. SUA transformed by RCS was added to the Cox regression model as an independent variable, and all-cause and CVD mortality scores were calculated. Survival receiver operating characteristic curves were produced using a regression model predicting the score.Results: SUA demonstrated a “U-shaped” relationship with all-cause and cardiovascular mortality. SUA predicted all-cause and CVD mortality, with cutoff values of values of &gt;370.5 μmol/L for males and &gt;327.65 μmol/L for females and &lt;180.5 μmol/L for males and &lt;165.7 μmol/L for females, respectively. The survival ROC curve indicated that SUA is able to predict all-cause and CVD mortality, with areas under the curve of 0.702 and 0.711, respectively. The HRs of all-cause mortality (male and female) with hyperuricemia and hypouricemia were 2.08 and 2.01 and 2.04 and 1.98, respectively, and the HRs of CVD mortality (male and female) were 2.09 and 1.79, and 2.02 and 1.89, respectively.Conclusion: Abnormal SUA levels were significant and independent risk factors for all-cause and CVD mortality. Hyperuricemia and hypouricemia increased mortality in both males and females. Routine SUA evaluation and intensive management are needed for HAR patients.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03616769.

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