Evaluation of the association between serum uric acid level and the predicted risk score of sudden cardiac death in five years in patients with hypertrophic cardiomyopathy [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2018; 46(2): 111-120 | DOI: 10.5543/tkda.2017.60094

Evaluation of the association between serum uric acid level and the predicted risk score of sudden cardiac death in five years in patients with hypertrophic cardiomyopathy

Sinem Özyılmaz1, Muhammet Hulusi Satılmışoğlu1, Mehmet Gül1, Huseyin Uyarel2, Osman Akin Serdar3
1Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Department of Cardiology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
3Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey


OBJECTIVE
The aim of this study was to determine the relationship between serum uric acid (UA) level and the predicted risk score for sudden cardiac death in 5 years (the HCM Risk-SCD), galectin-3 level, and positive fragmented QRS (fQRS) on electrocardiography (ECG) in patients with hypertrophic cardiomyopathy (HCM).

METHODS
This was a prospective, observational study. In all, 115 consecutive patients (age >17 years) with HCM and 80 healthy participants were included in the study. The HCM Risk-SCD score (%), galectin-3 level, and fQRS on ECG were evaluated in all patients.

RESULTS
The serum UA, galectin-3 level, UA/Creatinine ratio, incidence of ventricular tachycardia (VT) and syncope, and some echocardiographic parameters were significantly higher in the patient group than in the control group (all p<0.05). The UA value was significantly higher in patients with a high score on the HCM Risk-SCD, a positive fQRS, a high galectin-3 level, VT incidence, and need for implantable cardioverter defibrillator (ICD) implantation or cardiopulmonary resuscitation (CPR) than in those without (HCM Risk-SCD >6%. Namely, HCM Risk-SCD >6%, UA: 6.71±1.29 mg/dL, HCM Risk-SCD ≤5.9%, UA: 5.84±1.39 mg/dL, p=0.001; fQRS(+), UA: 6.56±1.20 mg/dL, fQRS(-), UA: 5.63±1.49 mg/dL, p<0.001; galectin-3 >6.320 pg/mL, UA: 6.56±1.27 mg/dL, galectin-3 ≤6.310 pg/mL, p=0.016; left atrium anterior-posterior dimension (LAAPD) >36 mm, UA: 6.31±1.33 mg/dL, LAAPD <36 mm, UA: 5.20±1.60 mg/dL, p=0.005; VT(+), UA: 6.83±1.19 mg/dL, VT(-), UA: 5.97±1.42 mg/dL, p=0.008; ICD(+), UA: 7.08±0.88 mg/dL, ICD(-), UA: 6.06±1.42 mg/dL, p=0.022; CPR(+), UA: 7.03±0.96 mg/dL, CPR(-), UA: 6.04±1.42 mg/dL, p=0.018. A statistically significant correlation was observed between UA and HCM Risk-SCD, galectin-3 level, LAAPD, and left ventricular (LV) mass (LVM) (r and p values, respectively: 0.355, <0.001; 0.297, 0.002; 0.309, 0.001; 0.276, 0.003.

CONCLUSION
The serum UA level was significantly higher in patients with HCM compared with the control group. A high UA level was associated with a higher HCM Risk-SCD score, positive fQRS, higher galectin-3 level, greater LAAPD, VT incidence, and the need for ICD implantation and CPR in patients with HCM.

Keywords: Cardiomyopathy, hypertrophic; risk; sudden cardiac death; uric acid.

How to cite this article
Sinem Özyılmaz, Muhammet Hulusi Satılmışoğlu, Mehmet Gül, Huseyin Uyarel, Osman Akin Serdar. Evaluation of the association between serum uric acid level and the predicted risk score of sudden cardiac death in five years in patients with hypertrophic cardiomyopathy. Turk Kardiyol Dern Ars. 2018; 46(2): 111-120

Corresponding Author: Sinem Özyılmaz, Türkiye
© Copyright 2018 Archives of the Turkish Society of Cardiology
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