Serum Uric Acid is an Independent Predictor for All-Cause Death and Rehospitalization in Patients with Acute Decompensated Heart Failure: Insights from KCHF Registry

Abstract

Background Heart failure (HF) can be associated with higher serum uric acid (SUA) levels. Although higher SUA in stable chronic HF were reported to have worse outcomes, underlying pathophysiology and causal role of SUA in HF is unclear. The aim of this study was to test the hypothesis that SUA at admission or discharge could be an independent predictor for all-cause death and re-hospitalization in patients with acute decompensated heart failure (ADHF). Methods and Results This is post-hoc analysis from a prospective, observational, multicenter cohort study, enrolling consecutive 3,717 ADHF patients from 19 participating hospitals in Japan from October 2014 and March 2016. Patients were divided into tertile of SUA at discharge, which was stratified by sex. The mean SUA at discharge was 7.13±2.10 mg/dl in male and 6.98±2.26 mg/dl in female, respectively. During a mean follow-up of 1.1±0.7 years, there were 575 deaths and 662 HF hospitalization. Higher SUA at discharge was associated with worse outcomes, defined as a composite of all-cause death and HF rehospitalization in both male and female (Figure). After multivariable adjustment including age, body mass index, ischemic etiology, hypertension, diabetes mellitus, hyperlipidemia, prior stroke, COPD, smoking, reduce LVEF ( Conclusions Higher SUA both at admission and discharge were associated with worse outcomes in ADHF patients. We should account for SUA as a predictor for all-cause death and HF rehospitalization in ADHF patients.