The impact of serum uric acid on cardiovascular outcomes in the LIFE study

IntroductionSerum uric acid levels have been reported as predictors of cardiovascular, pulmonary, neurological and renal morbidity in patients with SLE. However, their role in cumulative global damage in these patients has not yet been determined.ObjectiveTo determine whether serum uric acid levels are associated with new damage in patients with SLE.MethodsThis is a longitudinal study of patients with SLE from the Almenara Lupus Cohort, which began in 2012. At each visit, demographic and clinical characteristics were evaluated, such as activity (Systemic Lupus Erythematosus Disease Activity Index-2K or SLEDAI-2K) and cumulative damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index or SDI). Treatment (glucocorticoids, immunosuppressive drugs and antimalarials) was also recorded. Univariable and multivariable Cox regression models were used to determine the impact of serum uric acid levels on the risk of new damage.ResultsWe evaluated 237 patients, with a mean age (SD) at diagnosis of 35.9 (13.1) years; 220 patients (92.8%) were women, and the duration of the disease was 7.3 (6.6) years. The mean SLEDAI-2K and SDI scores were 5.1 (4.2) and 0.9 (1.3), respectively. Serum uric acid level was 4.5 (1.4) mg/dL. Follow-up time was 3.1 (1.3) years, and 112 (47.3%) patients accrued damage during follow-up. In univariable and multivariable analyses, serum uric acid levels were associated with new damage (HR=1.141 (95% CI 1.016 to 1.282), p=0.026; HR=1.189 (95% CI 1.025 to 1.378), p=0.022, respectively).ConclusionHigher serum uric acid levels are associated with global damage in patients with SLE.

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Serum Uric Acid Level as a Harbinger of Type 2 Diabetes: A Prospective Observation in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072277 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2277 ◽

Cited By ~ 1

Author(s):

Wen-Chih Wu ◽

Yen-Wen Lai ◽

Yu-Ching Chou ◽

Yu-Chan Liao ◽

San-Lin You ◽

...

Keyword(s):

Type 2 Diabetes ◽

Uric Acid ◽

Serum Uric Acid ◽

Diabetes Risk ◽

Current Evidence ◽

Study Cohort ◽

The Future ◽

Future Risk ◽

The Impact

Background: Current evidence suggests an association of uric acid with diabetes risk, but it is still unclear whether uric acid is merely a risk marker or an independent risk factor. We evaluate the impact of serum uric acid (SUA) levels on the future risk of developing type 2 diabetes, independent of other factors. Methods: A population-based cohort study was conducted among 4130 participants who were found to be free of type 2 diabetes at baseline recruitment in 2002. Baseline SUA measured in 2002 was longitudinally related to the incident type 2 diabetes that occurred during the follow-up period between 2002 and 2007. Hazard ratios (HRs) and 95% confidence intervals (CIs) derived from Cox proportional hazards models were used to quantify the association. Results: There was a graded increase in the incidence of type 2 diabetes among individuals with increasing levels of SUA. In the whole study cohort, compared to quartile 1, the multivariable-adjusted HRs (95% CIs) of type 2 diabetes in quartile 2, quartile 3, and quartile 4 were 1.69 (0.76–3.76), 1.86 (0.88–4.26), and 1.94 (1.05–4.05), respectively (P for trend = 0.004). This positive gradient for the risk of type 2 diabetes across quartiles of SUA was evident in both genders and across age groups. Conclusions: This study supports that high uric acid concentrations are associated with increased diabetes risk, independent of other known risk factors. These data expand on well-established associations between SUA level and metabolic syndrome, and extend the link to the future risk of type 2 diabetes.

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TCT-402 Serum uric acid levels predict longterm adverse cardiovascular outcomes after cardiac transplantation

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2018.08.1561 ◽

2018 ◽

Vol 72 (13) ◽

pp. B162

Author(s):

Megha Prasad ◽

Jaskanwal Deep Sara ◽

Richard Daly ◽

Lilach Lerman ◽

...

Keyword(s):

Uric Acid ◽

Serum Uric Acid ◽

Cardiac Transplantation ◽

Cardiovascular Outcomes

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Prognostic Value of Serum Uric Acid in Patients on the Waiting List before and after Renal Transplantation

International Journal of Nephrology ◽

10.1155/2015/375606 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Henrique Cotchi Simbo Muela ◽

Jose Jayme Galvão De Lima ◽

Luis Henrique W. Gowdak ◽

Flávio J. de Paula ◽

Luiz Aparecido Bortolotto

Keyword(s):

Uric Acid ◽

Renal Transplantation ◽

Serum Uric Acid ◽

Prognostic Value ◽

Independent Risk Factor ◽

High Serum ◽

Increased Risk ◽

Before And After ◽

The Impact ◽

The Relationship

Background.High serum uric acid (UA) is associated with increased cardiovascular (CV) risk in the general population. The impact of UA on CV events and mortality in CKD is unclear.Objective.To assess the relationship between UA and prognosis in hemodialysis (HD) patients before and after renal transplantation (TX).Methods.1020 HD patients assessed for CV risk and followed from the time of inception until CV event, death, or TX (HD) or date of TX, CV event, death, or return to dialysis (TX).Results.821 patients remained on HD while 199 underwent TX. High UA (≥428 mmol/L) was not associated with either composite CV events or mortality in HD patients. In TX patients high UA predicted an increased risk of events (P=0.03, HR 1.6, and 95% CI 1.03–2.54) but not with death. In the Cox proportional model UA was no longer significantly associated with CV events. Instead, a reduced GFR (<50 mL/min) emerged as the independent risk factor for events (P=0.02, HR 1.79, and % CI 1.07–3.21).Conclusion.In recipients of TX an increased posttransplant UA is related to higher probability of major CV events but this association probably caused concurrent reduction in GFR.

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Cumulative Serum Uric Acid and Its Time Course Are Associated With Risk of Myocardial Infarction and All‐Cause Mortality

Journal of the American Heart Association ◽

10.1161/jaha.120.020180 ◽

2021 ◽

Author(s):

Xue Tian ◽

Anxin Wang ◽

Shouling Wu ◽

Yingting Zuo ◽

Shuohua Chen ◽

...

Keyword(s):

Myocardial Infarction ◽

Uric Acid ◽

Serum Uric Acid ◽

Exposure Duration ◽

Time Course ◽

Cumulative Exposure ◽

Negative Slope ◽

Accumulation Time ◽

All Cause Mortality ◽

The Impact

Background Serum uric acid (SUA) has been demonstrated as a risk factor for myocardial infarction (MI) and all‐cause mortality; however, the impact of cumulative SUA (cumSUA) remains unclear. We aimed to investigate the association of cumSUA with MI risk and all‐cause mortality, and to further explore the effects of SUA accumulation time course. Methods and Results The study enrolled 53 463 participants without a history of MI, and these participants underwent 3 examinations during 2006 to 2010. cumSUA from baseline to the third examination was calculated, multiplying mean values between consecutive examinations by time intervals between visits. Cox models estimated hazard ratios (HRs) and 95% CIs of MI and all‐cause mortality for cumSUA quartiles, hyperuricemia exposure duration, and SUA accumulation time course. During a median follow‐up of 7.04 years, 476 incident MIs and 2692 deaths occurred. In the fully adjusted model, a higher MI risk was observed in the highest cumSUA quartile (HR, 1.48; 95% CI, 1.10–1.99), in participants with longer hyperuricemia exposure duration (HR, 1.71; 95% CI, 1.06–2.73), and in participants with cumSUA≥median and a negative slope (HR, 1.58; 95% CI, 1.18–2.11). Similar associations persisted for all‐cause mortality. Conclusions The risk of MI and all‐cause mortality increased with higher cumSUA and was affected by the SUA accumulation time course. Early SUA accumulation contributed more to MI risk and all‐cause mortality than later SUA accumulation with the same overall cumulative exposure, emphasizing the importance of optimal SUA control early in life.

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Serum uric acid, influence of sacubitril–valsartan, and cardiovascular outcomes in heart failure with preserved ejection fraction: PARAGON‐HF

European Journal of Heart Failure ◽

10.1002/ejhf.1984 ◽

2020 ◽

Vol 22 (11) ◽

pp. 2093-2101 ◽

Cited By ~ 1

Author(s):

Senthil Selvaraj ◽

Brian L. Claggett ◽

Marc A. Pfeffer ◽

Akshay S. Desai ◽

Finnian R. Mc Causland ◽

...

Keyword(s):

Heart Failure ◽

Uric Acid ◽

Ejection Fraction ◽

Serum Uric Acid ◽

Cardiovascular Outcomes ◽

Preserved Ejection Fraction

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The impact of serum uric acid level on arterial stiffness and carotid atherosclerosis: The Korean Multi-Rural Communities Cohort study

Atherosclerosis ◽

10.1016/j.atherosclerosis.2013.08.017 ◽

2013 ◽

Vol 231 (1) ◽

pp. 145-151 ◽

Cited By ~ 27

Author(s):

Ji Suk Bae ◽

Dong Hoon Shin ◽

Pil Sook Park ◽

Bo Youl Choi ◽

Mi Kyung Kim ◽

...

Keyword(s):

Uric Acid ◽

Cohort Study ◽

Rural Communities ◽

Arterial Stiffness ◽

Serum Uric Acid ◽

Uric Acid Level ◽

Acid Level ◽

Carotid Atherosclerosis ◽

Serum Uric Acid Level ◽

The Impact

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Relationship of hyperuricemia with mortality in heart failure patients with preserved ejection fraction

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00533.2015 ◽

2015 ◽

Vol 309 (7) ◽

pp. H1123-H1129 ◽

Cited By ~ 24

Author(s):

Takeshi Shimizu ◽

Akiomi Yoshihisa ◽

Yuki Kanno ◽

Mai Takiguchi ◽

Akihiko Sato ◽

...

Keyword(s):

Heart Failure ◽

Uric Acid ◽

Ejection Fraction ◽

Serum Uric Acid ◽

Decompensated Heart Failure ◽

Cardiopulmonary Exercise Test ◽

Preserved Ejection Fraction ◽

Reduced Ejection Fraction ◽

All Cause Mortality ◽

The Impact

Serum uric acid is a predictor of cardiovascular mortality in heart failure with reduced ejection fraction. However, the impact of uric acid on heart failure with preserved ejection fraction (HFpEF) remains unclear. Here, we investigated the association between hyperuricemia and mortality in HFpEF patients. Consecutive 424 patients, who were admitted to our hospital for decompensated heart failure and diagnosed as having HFpEF, were divided into two groups based on presence of hyperuricemia (serum uric acid ≥7 mg/dl or taking antihyperuricemic agents). We compared patient characteristics, echocardiographic data, cardio-ankle vascular index, and cardiopulmonary exercise test findings between the two groups and prospectively followed cardiac and all-cause mortality. Compared with the non-hyperuricemia group ( n = 170), the hyperuricemia group ( n = 254) had a higher prevalence of hypertension ( P = 0.013), diabetes mellitus ( P = 0.01), dyslipidemia ( P = 0.038), atrial fibrillation ( P = 0.001), and use of diuretics ( P < 0.001). Cardio-ankle vascular index (8.7 vs. 7.5, P < 0.001) and V̇e/V̇co2 slope (34.9 vs. 31.9, P = 0.02) were also higher. In addition, peak V̇o2 (14.9 vs. 17.9 ml·kg−1·min−1, P < 0.001) was lower. In the follow-up period (mean 897 days), cardiac and all-cause mortalities were significantly higher in those with hyperuricemia ( P = 0.006 and P = 0.004, respectively). In the multivariable Cox proportional hazard analyses after adjustment for several confounding factors including chronic kidney disease and use of diuretics, hyperuricemia was an independent predictor of all-cause mortality (hazard ratio 1.98, 95% confidence interval 1.036–3.793, P = 0.039). Hyperuricemia is associated with arterial stiffness, impaired exercise capacity, and high mortality in HFpEF.

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