Impact Of Hyperuricemia Research Articles

The Impact of Hyperuricemia on 24-month Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention with Drug-eluting Stents

Hyperuricemia is known to be associated with cardiovascular complications. However, there are limited data whether there is a clear association between hyperuricemia and long-term clinical outcomes of patients (pts) undergoing percutaneous coronary intervention (PCI) in drug-eluting stents (DESs) era.

Impact of Hyperuricemia on Coronary Artery Spasm as Assessed with Intracoronary Acetylcholine Provocation Test

Hyperuricemia is known to be associated with cardiovascular complications. However, there are limited data whether there is a clear association between hyperuricemia and significant coronary artery spasm (CAS) as assessed with intracoronary Acetylcholine (Ach) provocation test.

Changes in serum uric acid have a reciprocal effect on eGFR change: a 10-year follow-up study of community-based screening in Okinawa, Japan

Hyperuricemia is common among patients with hypertension and metabolic syndrome and therefore may be a cause of or result from these comorbid conditions. Few studies, however, have examined the relationship between the presence-absence of hyperuricemia and changes in the estimated glomerular filtration rate (eGFR) using the large cohort of the general population. We examined subjects who participated in two screenings, in 1993 and 2003, in Okinawa, Japan, yielding data on serum creatinine and uric acid levels (N=16,630). eGFR (ml min(-1) per 1.73 m(2)) was calculated using the formula used by the Japanese Society of Nephrology. In both sexes, a uric acid (UA) level >7.0 mg dl(-1) was defined as hyperuricemia (H), and a UA level below that threshold was classified as normouricemia (N). Based on the absence or presence of hyperuricemia in both the 1993 screening and the 2003 screening, we categorized patients into four groups: group 1, N/N; group 2, H/N; group 3, N/H; and group 4, H/H. Multiple regression analysis was performed to estimate the independent effects of several variables on the decline in eGFR. In all groups, an increase in UA from 1993 to 2003 (ΔUA) was a strong independent risk factor for a decline in eGFR than that of the baseline levels of UA, the presence of hypertension, or diabetes. The estimated decline in eGFR per 1 mg dl(-1) increase in UA was 4.19, 1.91, 2.36 and 2.01 ml min(-1) per 1.73 m(2) in groups 1, 2, 3 and 4, respectively. The results suggest that UA has a role in chronic kidney disease (CKD) progression. We have no information on medications used, such as xanthine oxidase, uricosuric drugs and hypotensives; therefore, the impact of hyperuricemia might be underestimated in our analysis. The results suggest that maintaining a normal range of UA is important to maintain eGFR decline in a normal range.

The Impact of Hyperuricemia on In-Hospital Mortality and Incidence of Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention

There is very little information about the relationship between hyperuricemia, acute kidney injury (AKI) and in-hospital mortality. With a retrospective analysis of the medical records, 1,247 patients who had percutaneous coronary intervention (PCI) were investigated. AKI was defined as an increase in serum creatinine of ≥0.5mg/dl or ≥50% over baseline within 7 days of PCI. The association of AKI with clinical, biochemical and procedural variables were examined. In addition, the association of hyperuricemia with in-hospital mortality was also examined. Of the 1,247 patients in the study population, 51 (4.1%) experienced AKI after PCI, 15 of whom required hemodialysis. In-hospital mortality occurred in 1.6% (20 of 1,247) in 19.6% (10 of 51) of AKI individuals, and 0.8% (10 of 1,186) of the non-AKI participants (odd ratios, 28.927; 95% confidence intervals, 11.411-73.328; P<0.001). In our study, the most powerful predictors of these variables were acute myocardial infarction, baseline estimated glomerular filtration rate (eGFR) <60 ml·min(-1)·1.73 m(-2), diabetics mellitus, anemia and hyperuricemia. Notably, the incidence of AKI after PCI markedly increased in diabetic or hyperuricemic patients with a baseline eGFR of <60 ml·min(-1)·1.73 m(-2). It is clear that AKI develops due to multiple risk factors. Our results indicate that hyperuricemia is independently associated with an increased risk of in-hospital mortality and AKI in patients treated with PCI.

Uric Acid as a Factor in the Metabolic Syndrome

Hyperuricemia is a prevalent finding in patients presenting metabolic syndrome, although its clinical meaning is still controversial and often underestimated. Men and women have different serum urate levels at all ages, and the impact of hyperuricemia in cardiovascular and renal outcomes is generally associated with a worse prognosis in women. Recent studies also have called attention to another perspective on hyperuricemia, indicating that it may be not only a consequence of insulin resistance states but also a significant predictor of the development of metabolic syndrome. This review discusses recent evidence related to the clinical significance of hyperuricemia in both sexes and the potential benefits of lowering serum uric acid levels.