Serum uric acid as a simple risk factor in patients with rheumatic heart disease undergoing valve replacement surgery

Abstract

BackgroundWe evaluated the relationship between admission serum uric acid (SUA) and in-hospital and one-year mortality after valve replacement surgery (VRS) for patients with rheumatic heart disease (RHD). MethodsOne-thousand five-hundred thirty-six consecutive patients with RHD undergoing VRS were divided into 4 groups based on the quartiles of SUA on admission. The association between SUA and adverse outcomes was analyzed. ResultsThe in-hospital mortality (2.1% vs 2.6% vs 5.3% vs 7.7%, p<0.001) and postoperative acute kidney injury (AKI) (52.0% vs 52.6% vs 61.6% vs 63.3%, p=0.001) increased from the lowest to the highest SUA quartiles. SUA levels were negatively correlated with eGFR value (r=−0.426, p<0.001) and positively correlated with C-reactive protein value (r=0.103, p<0.001). ROC analysis showed that SUA had good predictive value for in-hospital death (AUC=0.665, p<0.001) and was similar to Euro score (Z=0.966, p=0.334). Multiple logistic regression analysis showed that SUA was independently associated with in-hospital (OR=1.21, 95% CI: 1.06, 1.37, p=0.004) and one-year mortality (HR=1.17, 95% CI: 1.05, 1.29, p=0.003). Kaplan–Meier analysis demonstrated that the cumulative rate of one-year mortality after surgery was higher in patients with SUA>7.3mg/dl (Log-rank=21.1, p<0.001). ConclusionsAdmission SUA could be used as a preoperative risk assessment factor in RHD patients who underwent VRS.