Hyperuricemia in acute heart failure. More than a simple spectator?

Eur J Intern Med. 2009 Jan;20(1):74-9. doi: 10.1016/j.ejim.2008.04.007. Epub 2008 Jun 10.

Abstract

Background: Hyperuricemia is a prevalent condition in chronic heart failure (CHF), describing increased oxidative stress and inflammation. Although there is evidence that serum uric acid (UA) predicts mortality in CHF, its role as a prognostic biomarker in acute heart failure (AHF) has not yet been well assessed. The aim of this study was to determine if UA levels predict all-cause mortality. Additionally, as a secondary endpoint we sought the clinical predictors of UA serum level in this population.

Methods: We analyzed 560 consecutive patients with AHF admitted in a single university center. UA (mg/dl) was measured during early hospitalization. Patient survival status was followed up after discharge (median follow-up: 330 days). The independent association of UA level with all-cause mortality was analyzed using Cox regression analysis.

Results: During follow-up 165 (29.5%) deaths were identified. Patients with UA levels above the median value (>or=7.7 mg/dl) exhibited higher mortality rates (21.1 vs. 37.9%; p<0.001). In multivariable analysis, after adjusting for recognized prognostic factors and potential confounders, UA>or=7.7 mg/dl and per change in 1 mg/dl of UA was associated with an increased risk of mortality (HR 1.45, CI 95%=1.03-2.44; p=0.03 and HR 1.08, CI 95%=1.01-1.15; p=0.03, respectively).

Conclusion: UA serum levels is an independent predictor of all-cause mortality in an unselected patients admitted with AHF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Female
  • Follow-Up Studies
  • Heart Failure / blood*
  • Heart Failure / mortality*
  • Humans
  • Hyperuricemia / blood*
  • Hyperuricemia / mortality*
  • Male
  • Multivariate Analysis
  • Oxidative Stress
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Uric Acid / blood*

Substances

  • Uric Acid