Association between Serum Uric Acid and Mortality among Chinese Patients with Coronary Artery Disease

Cardiology ◽  
2016 ◽  
Vol 134 (3) ◽  
pp. 347-356 ◽  
Author(s):  
Qing Li ◽  
Yuan Zhang ◽  
Ding Ding ◽  
Yunou Yang ◽  
Qian Chen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Uric Acid ◽  
Coronary Artery ◽  
Serum Uric Acid ◽  
Cox Regression ◽  
Chinese Patients ◽  
Risk Of Death ◽  
Increased Risk ◽  
Artery Disease ◽  
Cvd Mortality

Objectives: Several studies have investigated the association between serum uric acid (SUA) and the risks of coronary artery disease (CAD) but have yielded inconsistent results. The aim of this study was to assess whether there is an independent association of SUA with all-cause and cardiovascular disease (CVD) mortality in Chinese patients with CAD. Methods: A prospective cohort study of 1,799 patients was conducted. Cox regression models were used to estimate the association of SUA with the risk of death. Results: During a median follow-up of 3.9 years, 177 deaths were recorded and 126 of these were due to CVD. Patients in the highest SUA quartile had a 2.43-fold risk of all-cause mortality and a 2.44-fold risk of CVD mortality compared with those in the lowest quartile. In the subpopulation analysis, the association between SUA and mortality remained similar when participants were stratified by age, gender, body mass index and type of CAD. In contrast, we found a significant interaction with estimated glomerular filtration rate (eGFR). There was a stronger association between SUA and the risk of all-cause and CVD mortality among patients with an eGFR ≥60 ml/min/1.73 m2, but no significant association was found in the population with an eGFR <60 ml/min/1.73 m2. Conclusions: Elevated SUA levels were positively associated with an increased risk of all-cause and CVD mortality among CAD patients.

Abstract P85: Are Myocardial Bridges Associated With Increased Risk of Death or Myocardial Infarction?

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Mouaz H Al-Mallah ◽  
Kamal Kassem ◽  
Owais Khawaja ◽  
Thomas Song ◽  
Chad Poopat ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Cox Regression ◽  
Study Cohort ◽  
Risk Of Death ◽  
Increased Risk ◽  
Artery Disease

Background: Myocardial bridging (MB) is frequently seen on coronary CT angiography (CCTA). However, there has been conflicting data on the prognostic value of MB. The aim of this analysis is to determine the prognostic value of MB in patients without obstructive coronary artery disease (CAD) (<50 diameter stenosis). Methods: We included patients with no known prior coronary artery disease (CAD) who underwent CCTA for various clincial reasons. Patients with obstructive CAD on CCTA were excluded. The study cohort was followed for all cause mortality or myocardial infarction (MI) (median follow-up 1.7 years). Group comparisons were made between patients with patients with or without MB. Results: A total of 715 patients were included in this analysis of which 68 patients had MB (10%). 73% of the bridges were in the mid LAD and 22% had bridging in the distal LAD. 48% of the study cohort had normal coronaries, while 52% had evidence of non obstructive CAD. There were no differences in the baseline characteristics, symptomatic status or prevalence of non obstructive CAD between the two groups (all p>0.5). After a median follow-up duration of 1.7 years, 23 patients died and 10 patients experienced myocardial infarction. There were no statistically significant differences in the rate of death/MI between the two groups (figure). Using multivariable Cox regression, the presence of MB was not associated with increased risk for death/MI (Adjusted HR 0.4, 95% confidence interval 0.1 -2.8, p=0.34) Conclusions: In patients with non-obstructive CAD, MB is not associated with increased risk for all cause death or MI.

scholarly journals Hyperuricemia and Hypertension, Coronary Artery Disease, Kidney Disease: From Concept to Practice

2020 ◽  
Vol 21 (11) ◽  
pp. 4066 ◽  
Author(s):  
Mélanie Gaubert ◽  
Thomas Bardin ◽  
Alain Cohen-Solal ◽  
François Diévart ◽  
Jean-Pierre Fauvel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Renal Function ◽  
Uric Acid ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Elevated Serum ◽  
Renal Diseases ◽  
Increased Risk ◽  
Artery Disease

Since the publication of the Framingham Heart Study, which suggested that uric acid should no longer be associated with coronary heart disease after additional adjustment for cardiovascular disease risk factors, the number of publications challenging this statement has dramatically increased. The aim of this paper was to review and discuss the most recent studies addressing the possible relation between sustained elevated serum uric acid levels and the onset or worsening of cardiovascular and renal diseases. Original studies involving American teenagers clearly showed that serum uric acid levels were directly correlated with systolic and diastolic pressures, which has been confirmed in adult cohorts revealing a 2.21-fold increased risk of hypertension. Several studies involving patients with coronary artery disease support a role for serum uric acid level as a marker and/or predictor for future cardiovascular mortality and long-term adverse events in patients with coronary artery disease. Retrospective analyses have shown an inverse relationship between serum uric acid levels and renal function, and even a mild hyperuricemia has been shown to be associated with chronic kidney disease in patients with type 2 diabetes. Interventional studies, although of small size, showed that uric acid (UA)-lowering therapies induced a reduction of blood pressure in teenagers and a protective effect on renal function. Taken together, these studies support a role for high serum uric acid levels (>6 mg/dL or 60 mg/L) in hypertension-associated morbidities and should bring awareness to physicians with regards to patients with chronic hyperuricemia.

scholarly journals UGT1A1 rs4148323 A Allele is Associated With Increased 2-Hydroxy Atorvastatin Formation and Higher Death Risk in Chinese Patients With Coronary Artery Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
He-Ping Lei ◽  
Min Qin ◽  
Li-Yun Cai ◽  
Hong Wu ◽  
Lan Tang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ultra Performance Liquid Chromatography ◽  
Chinese Patients ◽  
Tissue Samples ◽  
Human Liver Tissue ◽  
Death Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
Artery Disease

It is widely accepted that genetic polymorphisms impact atorvastatin (ATV) metabolism, clinical efficacy, and adverse events. The objectives of this study were to identify novel genetic variants influencing ATV metabolism and outcomes in Chinese patients with coronary artery disease (CAD). A total of 1079 CAD patients were enrolled and followed for 5 years. DNA from the blood and human liver tissue samples were genotyped using either Global Screening Array-24 v1.0 BeadChip or HumanOmniZhongHua-8 BeadChip. Concentrations of ATV and its metabolites in plasma and liver samples were determined using a verified ultra-performance liquid chromatography mass spectrometry (UPLC-MS/MS) method. The patients carrying A allele for the rs4148323 polymorphism (UGT1A1) showed an increase in 2-hydroxy ATV/ATV ratio (p = 1.69E−07, false discovery rate [FDR] = 8.66E−03) relative to the value in individuals without the variant allele. The result was further validated by an independent cohort comprising an additional 222 CAD patients (p = 1.08E−07). Moreover, the rs4148323 A allele was associated with an increased risk of death (hazard ratio [HR] 1.774; 95% confidence interval [CI], 1.031–3.052; p = 0.0198). In conclusion, our results suggested that the UGT1A1 rs4148323 A allele was associated with increased 2-hydroxy ATV formation and was a significant death risk factor in Chinese patients with CAD.

scholarly journals Limitations of Cox Proportional Hazards Analysis in Mortality Prediction of Patients with Acute Coronary Syndrome

2015 ◽  
Vol 43 (1) ◽  
pp. 33-48 ◽  
Author(s):  
Magdalena Babińska ◽  
Jerzy Chudek ◽  
Elżbieta Chełmecka ◽  
Małgorzata Janik ◽  
Katarzyna Klimek ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Uric Acid ◽  
Coronary Artery ◽  
Cox Regression ◽  
Proportional Hazard ◽  
Proportional Hazard Assumption ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Artery Disease

Abstract The aim of this study was to evaluate the possibility of incorrect assessment of mortality risk factors in a group of patients affected by acute coronary syndrome, due to the lack of hazard proportionality in the Cox regression model. One hundred and fifty consecutive patients with acute coronary syndrome (ACS) and no age limit were enrolled. Univariable and multivariable Cox proportional hazard analyses were performed. The proportional hazard assumptions were verified using Schoenfeld residuals, χ2 test and rank correlation coefficient t between residuals and time. In the total group of 150 patients, 33 (22.0%) deaths from any cause were registered in the follow-up time period of 64 months. The non-survivors were significantly older and had increased prevalence of diabetes and erythrocyturia, longer history of coronary artery disease, higher concentrations of serum creatinine, cystatin C, uric acid, glucose, C-reactive protein (CRP), homocysteine and B-type natriuretic peptide (NT-proBNP), and lower concentrations of serum sodium. No significant differences in echocardiography parameters were observed between groups. The following factors were risk of death factors and fulfilled the proportional hazard assumption in the univariable model: smoking, occurrence of diabetes and anaemia, duration of coronary artery disease, and abnormal serum concentrations of uric acid, sodium, homocysteine, cystatin C and NT-proBNP, while in the multivariable model, the risk of death factors were: smoking and elevated concentrations of homocysteine and NT-proBNP. The study has demonstrated that violation of the proportional hazard assumption in the Cox regression model may lead to creating a false model that does not include only time-independent predictive factors.

Serum Uric Acid Levels, but Not rs7442295 Polymorphism of SCL2A9 Gene, Predict Mortality in Clinically Stable Coronary Artery Disease

2021 ◽  
Vol 46 (5) ◽  
pp. 100798
Author(s):  
Chiara Mozzini ◽  
Domenico Girelli ◽  
Angela Setti ◽  
Jacopo Croce ◽  
Filippo Stefanoni ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Uric Acid ◽  
Coronary Artery ◽  
Serum Uric Acid ◽  
Stable Coronary Artery Disease ◽  
Artery Disease

Abstract P049: Serum Uric Acid Levels Are Associated With Non-Calcified Coronary Plaque Independent of Traditional Cardiovascular Risk Factors in Patients With Psoriasis

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Youssef A Elnabawi ◽  
Amit K Dey ◽  
Agastya D Belur ◽  
Aditya Goyal ◽  
Jacob W Groenendyk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Uric Acid ◽  
Coronary Artery ◽  
Serum Uric Acid ◽  
Coronary Plaque ◽  
Chronic Inflammatory Disease ◽  
Human Model ◽  
Plaque Burden ◽  
Artery Disease

Introduction: Serum uric acid (sUA), a known inflammosome-inducer, is associated with prospective risk of coronary artery disease in a dose-dependent fashion. Psoriasis (PSO), a chronic inflammatory disease associated with elevated burden of systemic inflammation and subclinical coronary artery disease, provides a reliable human model to study how sUA may relate to non-calcified coronary plaque burden (NCB) measured by computed coronary tomography angiography (CCTA). Hypothesis: We hypothesized that sUA would directly associate with NCB beyond traditional cardiovascular (CV) risk factors. Methods: 103 consecutive PSO patients and 47 healthy volunteers (HV) underwent CCTA (320 detector row, Toshiba) for coronary plaque burden quantification using QAngio (Medis). PSO severity was assessed by Psoriasis Area Severity Score (PASI) and divided into severe PSO (PASI>10) and mild-moderate PSO (PASI<10). All patients had fasting blood draws for the measurement of sUA at a certified clinical lab. Results: PSO patients were older than HV and had a higher CV risk by Framingham risk score (FRS) (Table 1). We observed a significant trend towards increase in sUA among severe PSO, mild-moderate PSO, and HV groups (mean 6.4, 5.9, 5.4 respectively, p=0.02 for trend). A positive association was observed between sUA and NCB, which was stronger in severe PSO after adjustment for traditional CV risk, alcohol, statins, and systemic/biologic PSO treatment (Severe PSO: β=0.27, p<0.001; Mild-moderate PSO: β=0.18, p=0.03), not significant in HV (β=0.18, p=0.12). Conclusions: sUA is independently associated with NCB in states of chronic inflammation such as PSO, and as such, may potentially serve as a biomarker for subclinical coronary atherosclerosis. However, larger prospective studies of CV outcomes in chronic inflammatory diseases are needed to confirm these results.

scholarly journals Association of Longitudinal Change in High-Sensitivity Troponin with All-Cause Mortality in Coronary Artery Disease: The Heart and Soul Study

Cardiology ◽  
2020 ◽  
Vol 145 (2) ◽  
pp. 63-70
Author(s):  
Yaanik B. Desai ◽  
Rakesh K. Mishra ◽  
Qizhi Fang ◽  
Mary A. Whooley ◽  
Nelson B. Schiller
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Sensitivity ◽  
Community Dwelling ◽  
Longitudinal Change ◽  
Clinical Variables ◽  
Risk Of Death ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Artery Disease

Background: Serial increases in high-sensitivity cardiac troponin (hs-cTnT) have been associated with death in community-dwelling adults, but the association remains uninvestigated in those with coronary artery disease (CAD). Methods: We measured hs-cTnT at baseline and after 5 years in 635 ambulatory Heart and Soul Study patients with CAD. We also performed echocardiography at rest and after treadmill exercise at baseline and after 5 years. Participants were subsequently followed for the outcome of death. We used a multivariable-adjusted Cox proportional hazards model to evaluate the association between 5-year change in hs-cTnT and subsequent all-cause mortality. Results: Of the 635 subjects, there were 386 participants (61%) who had an increase in hs-cTnT levels between baseline and year 5 measurements (median increase 5.6 pg/mL, IQR 3.2–9.9 pg/mL). There were 182 deaths after a mean 4.2-year follow-up after the year 5 visit. After adjusting for clinical variables, a >50% increase in hs-cTnT between baseline and year 5 was associated with a nearly 2-fold increased risk of death from any cause (hazard ratio 1.7, 95% confidence interval 1.1–2.7). When addition of year 5 hs-cTnT was compared to a model including clinical variables and baseline hs-cTnT, there was a modest but statistically significant increase in C-statistic from 0.82 to 0.83 (p = 0.04). Conclusion: In ambulatory patients with CAD, serial increases in hs-cTnT over time are associated with an increased risk of death.

Gender Differences in the Role of Serum Uric Acid for Predicting Cardiovascular Events in Patients with Coronary Artery Disease

2007 ◽  
Vol 37 (5) ◽  
pp. 196 ◽  
Author(s):  
Dae-Woo Hyun ◽  
Ki-Hong Kim ◽  
Hyun-Ju Yoon ◽  
Taek-Geun Kwon ◽  
Ki-Young Kim ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Gender Differences ◽  
Uric Acid ◽  
Coronary Artery ◽  
Serum Uric Acid ◽  
Cardiovascular Events ◽  
Artery Disease
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