Serum Uric Acid and Risk of Chronic Heart Failure: A Systematic Review and Meta-Analysis.

Lina Miao,Ming Guo,Pengfei Chen,Deng Pan,Jianpeng Du,Yanqiao Yu,Jie Gao,Dazhuo Shi,Zhuhong Chen

doi:10.3389/fmed.2021.785327

Abstract

Objectives: A systematic review and meta-analysis was performed to evaluate the potential prognostic role of serum uric acid (SUA) in patients with chronic heart failure (CHF).Methods: The Embase, PubMed, Web of Science and Cochrane Library databases were searched up to 5 April 2021 for relevant publications. Random effects model was used to pool data. STATA15.0 software was used to perform meta-analysis. Heterogeneity was assessed using the Cochran Q statistic (significance level of P < 0.10) and I2 statistics (significance level of 50%).Results: Ultimately, 18 publications reporting adverse events in CHF patients were included. The results indicate reveal associations between a high level of SUA and the risk of all-cause mortality (HR 2.24, 95% CI 1.49–3.37), cardiovascular mortality (HR 1.14, 95% CI 1.06–1.23), and the composite of death or cardiac events (HR 1.26, 95% CI 1.01–1.56) in CHF patients. A 1 mg/dL increase in serum uric acid led to 4% (HR 1.04, 95% CI 1.02–1.05) and 9% (HR 1.09, 95% CI 1.03–1.17) increases in the risk of all-cause mortality and the composite endpoint of death or cardiac events in CHF patients, respectively.Conclusion: Serum uric acid is positively associated with the risk of adverse events in CHF patients. This study protocol has been registered at PROSPERO as CRD42021247084 (https://www.crd.york.ac.uk/PROSPERO).Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO.

Highlights

Chronic heart failure (CHF) is one of the most significant public health problems, and its prevalence is increasing as the population ages [1]
The results indicate reveal associations between a high level of serum uric acid (SUA) and the risk of all-cause mortality (HR 2.24, 95% confidence intervals (CIs) 1.49–3.37), cardiovascular mortality (HR 1.14, 95% CI 1.06–1.23), and the composite of death or cardiac events (HR 1.26, 95% CI 1.01–1.56) in CHF patients
A 1 mg/dL increase in serum uric acid led to 4% (HR 1.04, 95% CI 1.02–1.05) and 9% (HR 1.09, 95% CI 1.03–1.17) increases in the risk of all-cause mortality and the composite endpoint of death or cardiac events in CHF patients, respectively

Summary

Introduction

Chronic heart failure (CHF) is one of the most significant public health problems, and its prevalence is increasing as the population ages [1]. CHF leads to a deteriorating 5-year survival rate and poorer quality of life [2]. The high rate of repeated hospitalizations and the high cost of hospitalization have severely increased the burden on the healthcare system [3]. Hypertension, valvular heart disease, coronary artery disease, and obesity were identified as risk factors for heart failure [4]. Despite the improvement in patient management, the mortality of heart failure remains high, which calls for the need to identify other associated risk factors. Identification of CHF patients with poor prognosis is of great significance for the treatment of CHF

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