Association between Uric Acid and In-Hospital Heart Failure in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.

Cun-Fei Liu,Kai-You Song,Yan-Jin Wei,Wei-Ning Zhou,Gaetano Isola

doi:10.1155/2021/7883723

Abstract

Objective To investigate the association of serum uric acid levels with in-hospital heart failure (HF) in patients with acute myocardial infarction (AMI) who are undergoing percutaneous coronary intervention (PCI). Methods Two hundred sixteen patients with AMI who were treated with PCI were enrolled in our study. Univariate and multivariate logistic regression analyses were performed to estimate the associations between uric acid levels and the risk of in-hospital HF in AMI patients. Analyses of the areas under the receiver operating characteristic (ROC) curve were performed to determine the accuracy of uric acid levels in predicting in-hospital HF. Results A dose-response relationship was found for the incidence of in-hospital HF and levels of uric acid, showing increased HF from the lowest to the highest tertile of uric acid. Compared with subjects in the bottom tertile, the adjusted odds ratio for in-hospital HF was 1.92 (95% CI 0.70–5.24) and 3.33 (95% CI 1.18-9.46) in the second tertile group and the third tertile group, respectively. Every 1 mg/dl increase in the serum uric acid level was associated with a 1.60-fold increased risk of incident in-hospital HF (OR, 1.60; 95% CI 1.22–2.11; P = 0.001). ROC curve analysis showed that the optimal cut-off value of uric acid to predict in-hospital HF was 5.75 mg/dl with a sensitivity of 69.2% and specificity of 56.3%. Conclusions Our study showed that the serum uric acid level on admission is an independent predictor of in-hospital heart failure in patients with AMI.

Highlights

The treatment of acute myocardial infarction (AMI) has improved substantially during the past decade, AMI remains one of the most significant causes of annual deaths worldwide and was regarded as the largest health burden worldwide in 2030 [1]
Sixty-five patients were diagnosed with heart failure (HF) during hospitalization, and the prevalence of HF was 30.1% among all AMI patients
Regarding the baseline laboratory parameters, the inhospital HF group had significantly higher levels of CRP, uric acid, and BNP on admission and lower TG and eGFR (P = 0:019 and P < 0:001, respectively), while there was no significant difference in white blood cell count (WBC), TC, LDL-c, HDL-c, or ALT between the HF and non-HF groups

Summary

Introduction

The treatment of acute myocardial infarction (AMI) has improved substantially during the past decade, AMI remains one of the most significant causes of annual deaths worldwide and was regarded as the largest health burden worldwide in 2030 [1]. Heart failure (HF), either early in-hospital or late postdischarge HF after AMI, is a serious complication of AMI [2, 3], and HF complicating AMI has been associated with a much higher mortality and worse prognosis than HF without AMI [4,5,6]. Early identification of patients with AMI who are at high risk of developing HF is necessary to reduce AMI-related major adverse cardiovascular events. Elevated uric acid is a well-established risk factor for the development of future HF in community populations [8, 9]. Whether elevated uric acid is associated with HF in patients hospitalized with an incident AMI remains unclear. We investigated the association of serum uric acid levels with in-hospital HF in patients with AMI treated with percutaneous coronary intervention (PCI)

Methods

Results

Conclusion