Hyperuricemia and Cardiovascular Diseases in Very Elderly Patients with Coronary Artery Disease

Abstract

There are few data available on the prevalence of hyperuricemia and its possible association with cardiovascular diseases among the very elderly population. The main part of this study enrolled 320 very elderly hospitalized patients (aged 86.4 ± 5.0 years; females, 78.1%; males, 21.9%) with coronary artery disease (CAD) and arterial hypertension (AH). The second part of the study involved 48 patients younger than 60 years, who were hospitalized with CAD diagnosis for coronary angiography study. Patients with gout were excluded from analysis. Hyperuricemia was defined as serum uric acid (SUA) more than 340 μmol/l in women and 420 μmol/l in men. Elevated serum uric acid (SUA) levels were detected in 37.4% of 320 elderly patients. Hyperuricemia was significantly more common in women (in 41.5% of cases) than in men (in 25%) (p = 0.02). In the group of very elderly patients, there was a clear correlation between hyperuricemia and clinically significant chronic heart failure (OR = 5.0; 95% CI = 2.4–10.7; p < 0.0001), as well as with stroke in history (OR = 1.9; 95% CI = 1.0–3.4; p = 0.03). Hyperuricemia remained significant risk factor of heart failure in the multiple regression analysis (p < 0.001). Atrial fibrillation was significantly more frequently diagnosed in patients with hyperuricemia compared with patients with normal levels of uric acid (OR = 2.2; 95% CI = 1.3–3.6; p = 0.001). A pronounced positive correlation was found between the SUA levels and the diameter of the left atrium (r = 0.3; p = 0.000003). In the group of 48 CAD patients under 60 years of age, hyperuricemia was significantly associated with myocardial infarction (OR = 8.8; 95% CI = 2.0–38.9; p = 0.002) and chronic heart failure (OR = 6.9; 95% CI = 1.8–26.3; p = 0.003). In general, the obtained results indicate a significant prevalence of hyperuricemia in people with CAD. A significant relationship between the increased SUA levels and the development of some cardiovascular diseases was found.