0098 : Uric acid predict clinical outcomes in heart failure

Abstract

Heart failure (HF) has become a major epidemic and a significant public health problem, with considerable morbidity and mortality. Uric acid (UA) levels are frequently increased in patients with heart failure (HF), and may be an indicator of a poor prognosis and an innovative target for treatment. We evaluated the prognostic effect of UA on clinical outcome in patients with HF. In addition, we looked at the relation of UA to echocardiographic parameters in a subset of these patients. Totally 309 consecutive patients with chronic heart failure symptomatic class II, III, or IV were retrospectively studied. Clinical, electrocardiographic, echocardiographic and biological data were investigated. 84% of the patients had elevated UA (>70mg/L in men and >60mg/l in women). We divided patients on 2 groups: group 1 with hyperuricemia and group 2 without hyperuricemia. Mean UA levels were 71,4mg/l in group 1 and 42,2mg/l in group 2. Male sex, diabetes mellitus, hyperlipidemia, and ischemic heart disease were associated with higher UA levels. Increased urea and creatinine were also associated with higher UA levels, whereas reduced estimated glomerular filtration rate, hyponatremia treatment with furosemide were seen with higher UA levels. An increase in UA levels was a predictor of increased cardiac hospitalizations (p= 0.0001) and mortality (p<0.00039). Echocardiographic data demonstrated a significant correlation between UA levels and E/A ratio, a marker of diastolic dysfunction (p<0.0001). Increased UA level was independent predictor of increased morbidity and mortality in a cohort of ambulatory patients with chronic heart failure.