scholarly journals Study of serum uric acid level as a prognostic marker in acute ST elevation myocardial infarction patients

2018 ◽  
Vol 5 (3) ◽  
pp. 592
Author(s):  
Suresh Kumar Behera ◽  
Akshaya Kumar Samal

Background: The study was conducted to correlate serum uric acid levels with Killip class i.e. severity of heart failure in patients with ST elevation myocardial infarction (STEMI) and to assess any influence of serum uric acid levels on in-hospital mortality in STEMI patients.Methods: Authors evaluated 250 consecutive (STEMI) patients who were hospitalized within 24 hours of symptom onset from September 2015 to august 2017. Detailed history, physical examination was done as per a structured proforma and necessary laboratory investigations were done.Results: There was significant difference in mean serum uric acid level between diabetic and non-diabetic population. There was significant difference in mean uric acid level between hypertensive and non-hypertensive population. Serum uric acid level was high among STEMI patients with Killip class III and IV and low among patients with Killip class I and II. The higher the uric acid level was, the higher was the percentage of mortality during 5 days hospital course.Conclusions: Patients of higher Killip class had higher levels of serum uric acid as compared to patients of lower Killip class. Serum uric acid level when combined with Killip class is a good predictor of severity of heart failure and short-term mortality after STEMI.

Author(s):  
Piyush Gosar ◽  
Sutakshee Sonwani ◽  
Pravi Gosar ◽  
Bhawana Rani

Background: Present evidence shows that increased uric acid level is a negative prognostic factor in patients with moderate to severe heart failure. A study has highlighted a correlation between serum uric acid levels and Killip class in patients of acute myocardial infarction (AMI). Aim of this study the relationship between serum uric acid level and Killip classification in patients with AMI.Methods: Sixty patients with AMI were studied prospectively in Department of Medicine/ Department of Cardiology, JA Group of Hospitals between 2016-2018. Patients were grouped based on the Killip class. Age, sex, history of smoking, alcohol consumption, hypertension and diabetes were recorded. Serum uric acid level were measured on Day 1, 3 and 5, which was compared with Killip class.Results: Majority of the patients were males (65%) and had age between (28.3%) 51-60 years. No significant association was obtained between any risk factors of AMI and Killip’s class (p>0.05). Serum uric acid levels were significantly higher in Killip grade III (7.80±3.57) as compared to Killip’s grade II (6.64±2.88) and I (6.30±2.33) (p=0.014). Majority of the patients with Killip’s grades I and II, had uric acid level ≤7.0 mg/dl (n=18 and n=9 respectively) (p=0.040). Serum uric acid was equally distributed among different types of killip’s grades between patients who expired and survived. (p>0.05).Conclusions: Serum uric acid levels has been found to be well correlated with Killip classification in patients with AMI. Combination of Killip class and serum uric acid level after AMI is a good predictor of mortality after AMI.


2019 ◽  
Vol 6 (4) ◽  
pp. 1084
Author(s):  
Devendra Ajmera ◽  
Nirmal Kumar Sharma ◽  
Saurabh Chittora

Background: Serum uric acid is increased in ischemic conditions and is significantly higher in patients with acute myocardial infarction. The aim of study was to correlate serum uric acid level with KILLIP class in respect of mortality and morbidity profile of patients with acute coronary syndromes..Methods: 100 patients fulfilling the standard diagnostic criteria for acute coronary syndromes on the basis of classical history, clinical signs, ECG changes and biomarkers were included in the study. Age and sex matched 50 normal healthy subjects were also included as control group after obtaining informed consent.  Serum uric acid level was measured on day 0, 3 and 7 of various ACS.Results: There was statistically significant higher level of serum uric acid concentration in patients of AMI on day of admission as compared to controls and unstable angina patients. On all three days of serum uric acid estimation, the serum uric acid levels were higher in AMI patients who were in higher KILLIP class as compared to lower KILLIP class group. Smokers had significantly higher baseline serum uric acid but age, sex, dyslipidemia, hypertension and diabetes mellitus did not significantly affect serum uric acid level at any stage in various ACS patients. Five patients who died during hospital stay, had serum uric acid level more than 7.0 mg/dL and all of them were in KILLIP class III and IV.Conclusions: serum uric acid level is a strong and independent risk factor in predicting mortality and morbidity profile of patients of acute myocardial infarction. Also, serum uric acid level correlates well with KILLIP class.


2017 ◽  
Vol 4 (4) ◽  
pp. 1010
Author(s):  
Padma V. ◽  
Amogh Banupriya

Background: Higher uric acid is a negative prognostic factor in patients with mild to severe heart failure. Studies have shown that there is a close correlation between serum uric acid concentration and Killip classification in patients of acute myocardial infarction and uric acid levels are higher in patients with higher Killips class.Methods: We studied 100 patients with acute myocardial infarction and compared with 100 controls. Serum uric acid level was measured on day 0, 3 and 7 of MI and results were analysed.Results: Average uric acid level in male cases was 5.6 and female cases was 5.2, male controls were 4.2 and female controls was 3.6. Females had a higher mortality when compared with male patients. One female died due to MI on day 0, one male and two females died on day 3 and four males and four females died on day 7. All patients who died had higher uric acid levels.Conclusions: Serum uric acid levels are higher in patients of acute myocardial infarction as compared to normal healthy persons. Serum uric levels increases in patients with higher Killip class. Combination of Killip class and serum uric acid level after acute myocardial infarction is a good predictor of mortality after acute myocardial infarction.


2020 ◽  
Vol 7 (8) ◽  
pp. 1256
Author(s):  
Piyush Gosar ◽  
Ajay Pal Singh ◽  
Pravi Gosar ◽  
Bhawana Rani

Background: Elevated levels of serum uric acid are associated with increased cardiovascular morbidity and mortality. However, this association with cardiovascular diseases is still unclear, and perhaps controversial. The objective of study was to assess the serum uric acid level in patients with Acute Myocardial Infarction (AMI).Methods: Sixty patients with AMI were studied in Department of Medicine/ Department of Cardiology, J.A. Group of Hospitals between 2016 -2018.Details of age, sex, smoking, alcohol consumption and history of ischemic heart disease (IHD) was obtained and recorded. Serum uric acid level was estimated and compared with control group (healthy subjects).Results: Serum uric acid level was significantly higher among AMI patients (6.43±2.60) as compared to control group (4.05±0.95) (p<0.001). Majority (46.7%) of the AMI patients had uric acid level of >7.1 followed by 20% patients who had uric acid level between 4.5-5.9 (p<0.001). Uric acid level was comparable between smoker and non-smokers (p=0.803), alcoholic and non-alcoholic (p=0.086), hypertensive and non-hypertensive (p=0.668), patients with and without diabetes (p=0.278) and patients with a history of IHD and without history of IHD (p=0.403).Conclusions: Serum uric acid may be useful for prognostication among those with pre-existing AMI.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Satoshi Takahashi ◽  
Takahisa Yamada ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
...  

Background: Elevated uric acid level is associated with an increased risk of adverse outcome in patients with chronic heart failure (CHF). On the other hand, cardiac metaiodobenzylguanidine (MIBG) imaging provides prognostic information in patients with CHF. However, there is no information available on the prognostic value of cardiac MIBG imaging in CHF patients, relating to hyperuricemia. Methods: We enrolled 113 CHF outpatients (NYHA2.0±0.6, ischemic origin 48%) with radionuclide LVEF <40%(30±8%). The cardiac MIBG washout rate (WR) was calculated from the chest anterior view images obtained at 20 and 200 min after isotope injection. Abnormal WR was defined as >27% as reported previously. At the entry, we measured serum uric acid level and hyperuricemia was define as >7.0mg/dl. The primary end point was cardiac death. Reults: At the entry, 59 and 51 of 113 patients had abnormal WR and hyperuricemia, respectively. Serum uric acid level was significantly higher in patients with than without abnormal WR (7.3±1.8 vs 6.3±2.0 mg/dl, p=0.007). During the follow up period of 7.6±4.3 years, 35 patients had cardiac death. Cardiac death was significantly more often observed in patients with than without abnormal WR (47% vs 13%, p<0.001) and hyperuricemia (42% vs 23%, p=0.034). At multivariate Cox analysis, abnormal WR and hyperuricemia were significantly independently associated with cardiac death (p=0.02 and p=0.03, respectively). Patients with abnormal WR had a significantly greater risk of cardiac death than those with normal WR in group with hyperuricemia (p=0.004, harard ratio: 6.5, 95%CI 1.8 to 23.4) and without hyperuricemia(p=0.001, hazard ratio: 4.4, 95%CI 1.5 to 13.2). Conclusion: Cardiac MIBG imaging provides the additional information to hyperuricemia in CHF.


2017 ◽  
Vol 33 (2) ◽  
Author(s):  
Adnan Khan ◽  
Mohammad Hassan Shah ◽  
Sarbiland Khan ◽  
Umama Shamim ◽  
Sanan Arshad

2012 ◽  
Vol 5 (1) ◽  
pp. 12-17 ◽  
Author(s):  
MAK Akanda ◽  
KN Choudhury ◽  
MZ Ali ◽  
S Naher ◽  
ASME Islam ◽  
...  

Background: Few studies have assessed the relation of uric acid level with the severity of coronary  artery disease (CAD). This study investigated the association between high uric acid levels with the  presence and severity of CAD.Materials and Methods: This study was designed as an observational cohort study. The study was  composed of 180 patients admitted at our institution due to symptoms related to CAD. Patients  having angiographic evidence of stenosis in coronary artery were as case group and without stenosis  control group. Patients with high uric acid (hyperuricemia) were defined as serum uric acid  concentration ?7.0mg/dl or ?420 ?mol/L in men and ?6mg/dl or ?360 ? mol/L in women. The  presence of CAD has been defined as the Gensini score being ?1.  Results: There was a statistically significant difference between the mean uric acid levels of patients  with and without CAD (358.23±71.11 ?mol/l vs251.32±54.92 ?mol/l respectively, p<0.001). There  was a statistically significant difference between ejection fraction of patients with and without CAD  (54.50±9.25 vs. 63.16±6.56 respectively, p?0.001). Spearman correlation analysis demonstrated a  positive correlation between the serum uric acid level and the severity of CAD (p=?0.001, r=0.39).  When patients were classified into four groups according to their Gensini score, mean serum uric  acid level was found to be significantly increased across the tertiles, and a statistically significant  difference was detected between the tertiles (p= ?0.001).  Conclusion: In conclusion, a significant association has been found between serum uric acid level  and the presence and severity of CAD. In addition to the evaluation of conventional risk factors in  daily clinical practice, the measurement of uric acid level might provide significant prognostic  benefits in terms of global cardiovascular risk and management of the patients. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12206 Cardiovasc. j. 2012; 5(1): 12-17


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