The association between serum uric acid level and heart failure and mortality in the early period of ST-elevation acute myocardial infarction

OBJECTIVES
Uric acid (UA) is a strong marker of cardiovascular disease. Therefore, we aimed to determine the relationship between serum UA levels and cardiovascular events in patients in the early period of their acute myocardial infarction.

STUDY DESIGN
This retrospective study included 586 consecutive patients with ST-elevated myocardial infarction (STEMI) who were admitted to the hospital between March 2010 and February 2012. The study population was divided into two groups; the first group included hyperuricemic patients (n=107; uric acid level >6 mg/dl in women and >7 mg/dl in men), and the second group included patients with normal UA level (n=479). Multivariate analysis was used to demonstrate the predictive value of UA levels in groups.

RESULTS
Patients in the hyperuricemic group were older (median 66 years vs. 60 years, p=0.001), and the ratio of female patients was higher (35.5% vs. 16.9%, p=0.001). Patients with hyperuricemia had a significantly higher incidence of in-hospital cardiovascular mortality than the normal group (15.9% vs. 3.1%, p<0.001). Advanced heart failure (class ≥3) was more frequent among hyperuricemic patients (17.8% vs. 8.8%, p=0.006). Age ≥70 years, chest pain duration >6 hours and hyperuricemia (hazard ratio (HR): 1.83, 95% confidence interval: 1.02-3.27; p=0.041) were found to be independent predictors of advanced heart failure. Hyperuricemia was found to be an independent predictor of in-hospital cardiovascular mortality in multivariate analyses (HR: 5.32, 95% confidence interval: 2.46- 11.49; p=0.001).

CONCLUSION
This study showed that a high serum UA level is an independent predictor of cardiovascular mortality and morbidity during the in-hospital period of STEMI.